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Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

  • Chen, Shao-Bin (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Weng, Hong-Rui (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Wang, Geng (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Yang, Jie-Sheng (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Yang, Wei-Ping (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Liu, Di-Tian (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Chen, Yu-Ping (Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College) ;
  • Zhang, Hao (Department of Integrative Oncology, Cancer Hospital of Shantou University Medical College)
  • 발행 : 2013.06.30

초록

More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma (ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC, evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affecting lymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwent transthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed. The ${\chi}^2$ test or Fisher's exact test were used to detect factors related to lymph node metastasis. Univariate and multivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females with a median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining 20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computed tomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients with carcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumours and 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph node metastases in the follow-up. The 5- and 10-year overall survival rates were 81.4% and 70.1%, respectively. Only histologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph node metastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independent prognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade and pT category affected the presence of lymph node metastases and were independent prognostic factors for early ESCC.

키워드

참고문헌

  1. Altorki N, Kent M, Ferrara C, Port J (2002). Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg, 236, 177-83. https://doi.org/10.1097/00000658-200208000-00005
  2. Ancona E, Rampado S, Cassaro M, et al (2008). Prediction of lymph node status in superficial esophageal carcinoma. Ann Surg Oncol, 15, 3278-88. https://doi.org/10.1245/s10434-008-0065-1
  3. Barbour AP, Jones M, Brown I, et al (2010). Risk stratification for early esophageal adenocarcinoma: analysis of lymphatic spread and prognostic factors. Ann Surg Oncol, 17, 2494- 502. https://doi.org/10.1245/s10434-010-1025-0
  4. Bogoevski D, Bockhorn M, Koenig A, et al (2011). How radical should surgery be for early esophageal cancer? World J Surg, 35, 1311-20. https://doi.org/10.1007/s00268-011-1069-8
  5. Chen SB, Weng HR, Wang G, et al (2013). Prognostic factors and outcome for patients with esophageal squamous cell carcinoma underwent surgical resection alone: Evaluation of the seventh edition American Joint Committee on Cancer Staging System for esophageal squamous cell carcinoma. J Thorac Oncol, 8, 495-501. https://doi.org/10.1097/JTO.0b013e3182829e2c
  6. DeMeester SR(2010). Evaluation and treatment of superficial esophageal cancer. J Gastrointest Surg, 14, S94-100. https://doi.org/10.1007/s11605-009-1025-1
  7. Dubecz A, Gall I, Solymosi N, et al (2012). Temporal trends in long-term survival and cure rates in esophageal cancer: a SEER database analysis. J Thorac Oncol, 7, 443-7. https://doi.org/10.1097/JTO.0b013e3182397751
  8. Endo M, Yoshino K, Kawano T, Nagai K, Inoue H (2000). Clinicopathologic analysis of lymph node metastasis in surgically resected superficial cancer of the thoracic esophagus. Dis Esophagus, 13, 125-9. https://doi.org/10.1046/j.1442-2050.2000.00100.x
  9. Fujita H, Sueyoshi S, Yamana H, et al (2001). Optimum treatment strategy for superficial esophageal cancer: endoscopic mucosal resection versus radical esophagectomy. World J Surg, 25, 424-31. https://doi.org/10.1007/s002680020053
  10. Gertler R, Stein HJ, Langer R, et al (2011). Long-term outcome of 2920 patients with cancers of the esophagus and esophagogastric junction: evaluation of the New Union Internationale Contre le Cancer/American Joint Cancer Committee staging system. Ann Surg, 253, 689-98. https://doi.org/10.1097/SLA.0b013e31821111b5
  11. Grotenhuis BA, van Heijl M, Zehetner J, et al (2010). Surgical management of submucosal esophageal cancer: extended or regional lymphadenectomy? Ann Surg, 252, 823-30. https://doi.org/10.1097/SLA.0b013e3181fcd730
  12. Ishikawa H, Sakurai H, Yamakawa M, et al (2005). Clinical outcomes and prognostic factors for patients with early esophageal squamous cell carcinoma treated with definitive radiation therapy alone. J Clin Gastroenterol, 39, 495-500. https://doi.org/10.1097/01.mcg.0000165662.49036.2e
  13. Korn WM (2004). Prevention and management of early esophageal cancer. Curr Treat Options Oncol, 5, 405-16. https://doi.org/10.1007/s11864-004-0030-6
  14. Lerut T, Nafteux P, Moons J, et al (2004). Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma. Ann Surg, 240, 962-72. https://doi.org/10.1097/01.sla.0000145925.70409.d7
  15. Matsubara T, Ueda M, Abe T, et al (1999). Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic esophagus. Br J Surg, 86, 669-73. https://doi.org/10.1046/j.1365-2168.1999.01067.x
  16. Natsugoe S, Matsumoto M, Okumura H, Ikeda M, Ishigami S, Owaki T, Takao S, Aikou T (2004). Prognostic factors in patients with submucosal esophageal cancer. J Gastrointest Surg, 8, 631-5. https://doi.org/10.1016/j.gassur.2004.02.004
  17. Rice TW, Blackstone EH, Rusch VW (2010). 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol, 17, 1721-4. https://doi.org/10.1245/s10434-010-1024-1
  18. Rice TW, Rusch VW, Apperson-Hansen C, et al (2009). Worldwide esophageal cancer collaboration. Dis Esophagus, 22, 1-8. https://doi.org/10.1111/j.1442-2050.2008.00901.x
  19. Saha AK, Sutton CD, Sue-Ling H, Dexter SP, Sarela AI (2009). Comparison of oncological outcomes after laparoscopic transhiatal and open esophagectomy for T1 esophageal adenocarcinoma. Surg Endosc, 23, 119-24. https://doi.org/10.1007/s00464-008-0065-z
  20. Schlemper RJ, Riddell RH, Kato Y, et al (2000). The Vienna classification of gastrointestinal epithelial neoplasia. Gut, 47, 251-5. https://doi.org/10.1136/gut.47.2.251
  21. Stein HJ, Feith M, Bruecher BL, et al (2005). Early esophageal cancer: pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg, 242, 566-73.
  22. Sugimachi K, Ohno S, Matsuda H, et al (1989). Clinicopathologic study of early stage esophageal carcinoma. Br J Surg, 76, 759-63. https://doi.org/10.1002/bjs.1800760739
  23. Tachibana M, Kinugasa S, Shibakita M, et al (2006). Surgical treatment of superficial esophageal cancer. Langenbecks Arch Surg, 391, 304-21. https://doi.org/10.1007/s00423-006-0063-3
  24. Tajima Y, Nakanishi Y, Ochiai A, et al (2000). Histopathologic findings predicting lymph node metastasis and prognosis of patients with superficial esophageal carcinoma: analysis of 240 surgically resected tumors. Cancer, 88, 1285-93. https://doi.org/10.1002/(SICI)1097-0142(20000315)88:6<1285::AID-CNCR3>3.0.CO;2-R
  25. Tanaka T, Matono S, Nagano T, et al (2012). Esophagectomy with extended lymphadenectomy for submucosal esophageal cancer: long-term outcomes and prognostic factors. Ann Surg Oncol, 19, 750-6. https://doi.org/10.1245/s10434-011-2023-6
  26. Watanabe M, Suehara N, Koga K, et al (2010). Outcomes of endoscopic submucosal dissection and esophagectomy for early and superficial carcinoma of the esophagus. Esophagus, 7, 215-7. https://doi.org/10.1007/s10388-010-0249-1
  27. Westerterp M, Koppert LB, Buskens CJ, et al (2005). Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch, 446, 497-504. https://doi.org/10.1007/s00428-005-1243-1

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  5. Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502: a prospective multicenter study vol.29, pp.12, 2015, https://doi.org/10.1007/s00464-015-4102-4
  6. Association between positive murine double minute 2 expression and clinicopathological characteristics of esophageal squamous cell carcinoma: a meta-analysis vol.29, pp.7, 2015, https://doi.org/10.1111/dote.12361