同時性食道多発癌の臨床像  [in Japanese] A Clinical Study of Multiple Carcinoma of the Esophagus  [in Japanese]

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Abstract

目的:同時性食道多発癌と非多発癌とを比較し,臨床病理学的に検討した.方法:1995年〜2001年までの術前未治療であった食道癌切除例574例を対象に,同時性食道多発癌116例(19.7%)と非多発癌458例とを比較,検討した.多発癌症例はすべて3領域リンパ節郭清を伴う根治術がなされた.結果:同時性多発癌の頻度は19.7%で,非多発癌と比べ,(1)咽頭癌の併存が高頻度,(2)累積5年粗生存率において予後不良,である点で有意であった.性差,喫煙,アルコール摂取など疫学的因子やリンパ節転移陽性率などでは有意差は得られなかった.多発癌の副病巣について,(1)すべて表在癌でM癌が83.6%,(2)0-IIb, 0-IIcが89.7%,(3)腫瘍径1cm以下が58.8%,(4)主病巣の口側もしくは肛側3cm以内に73.3%が存在,といった特徴を有した.結語:食道多発癌は近年,内視鏡検査の精度向上に伴い発見率が増加しつつあり,内視鏡的粘膜切除(endoscopic mucosal resection)や外科的根治術,放射線化学療法などの治療法の選択,フォローアップの上で重要となると考えられた.

Purpose : We clinicopathologically evaluated multiple carcinoma of the esophagus. Methods : Among 574 patients with esophageal cancer undergoing esophagectomy or endoscopic mucosal resection (EMR) without preoperative treatment at Keiyuukai Sapporo Hospital between 1995 and 2001,116 (19.7%) had multiple carcinoma of the esophagus. All such patients underwent esophagectomy with 3 field lymph node resection. Results : Multiple carcinoma of the esophagus is characterized by (1) an incidence of pharyngeal malignancy significantly higher in patients with multiple carcinoma (P<0.001) ; (2) a statistically significant difference in overall 5-year survival rate ; (3) no significant difference between groups in the extent of lymph node metastasis or alcohol and smoking index or male-to-female ratio. Secondary lesions were characterized by (1) Mucosal cancer in 83.6% ; (2) Endoscopic type 0-IIb or 0-IIc lesions in 89.7% : (3) a maximum lesion length of < 1cm in 58.8% ; (4) a distance between the main tumor and the secondary lesion of <3cm in 73.3%. Conclusions : Multiple and multifocal tumors should be considered in the diagnosis, treatment, and follow-up of cancer of the esophagus.

Journal

  • The Japanese journal of gastroenterological surgery

    The Japanese journal of gastroenterological surgery 37(6), 627-632, 2004-06-01

    The Japanese Society of Gastroenterological Surgery

References:  7

Cited by:  1

Codes

  • NII Article ID (NAID)
    10013672897
  • NII NACSIS-CAT ID (NCID)
    AN00192066
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869768
  • Data Source
    CJP  CJPref  NII-ELS 
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