• 제목/요약/키워드: 식도암

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Surgical Treatment for Carcinoma of Esophagus (식도암의 외과적 치료)

  • 조민섭;윤정섭
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.40-47
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    • 1997
  • From January 1990 to March 1994, 61 patients with thoracic esophageal cancer were treated at our institute. We analyzed the medical records retrospec ively to fond any prognostic factors of esophageal cancer surgery. The age ranged from 36 years to 74 years and the mean age was 58.3 years. The sex ratio of men to women was 14: 1. The mean duration of dysphagia was 3.8 months and they mostly suffered from the dysphagia of grade IV. Tumors were staged postoperatively; 2 stage I, 23 Stage II, 27 stage III, 9 stage IV, and the resectability was 78.7%, Fortynlne patients underwent curative esophageal resection and 5 patients permitted palliative esophagogastrostomy with incomplete tumor resection. Five patients underwent feeding gastrostomy and 2 patients were managed with Celestin tube. The most common complication was atelectasis and pneumonia, and early mortality rate was 5.6%. There were 9 cases of identified local recurrence or distant metastasis. Estimated overall actuarial survival rate during the follow-up was 73.4% in 1 year, 54.7% in 2 years, and 23.1% In 4 years. The tumor stage higher than II(p=0.02) was confirmed as a poor prognostic factor.

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Role of Endoscopic Ultrasound in the Assessment of Superficial Esophageal Cancer (조기 식도암에서 내시경초음파의 역할)

  • Cho, Yu Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.19-22
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    • 2011
  • Endoscopic ultrasound in the diagnosis of esophageal carcinoma is an indispensable procedure, not only to discuss the preoperative staging of the lesion, but also to evaluate the therapeutic effect of chemo-radiation therapy. The recent increase in the incidence of superficial esophageal cancer and promising developments in potentially curative endoscopic therapies have placed EUS to a central position in decision making. Recent data have called into question the staging accuracy of EUS to distinguish mucosal from submucosal lesions, particularly in patients with early disease. In those cases, diagnostic endoscopic resection may be useful for staging and curative in superficial lesions. Nonetheless, EUS has been regarded as the most accurate staging tool and should be performed to identify potential candidates for endoscopic resection.

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Radiation Treatment of Esophageal Cancer (식도암의 방사선치료)

  • Oh W. Y.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.41-50
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    • 1985
  • 63 patients who were irradiated with a goal of long term control among 101 patients with esophageal cancer seen during an 11 fears period between Jan, 1970 and Dec, 1980 at Yonsei Cancer Center in Seoul, Korea have retrospectively analysed. 52(82.5%) among the 63 Patients were confirmed to have epidermoid carcinoma in the histology. 46 cases(73.0%) except 17 cases of $T_1$, were locally or far advanced extension. Tumor dose of radical radiation in the management of esophageal cancer had delivered from 50 Gy to 74 Gys. 2 Gys daily fractions, between 5weeks and 8 weeks. After 1 month from the completion of radiation, 23 of the 63 patients had a repeat barium esophagogram for the assessment of tumor response, there had showed 7 cases of complete response and 15 cases of partial response. 45(71.4%) patients were followed up and the remaining 18 patients were lost to follow-up within 1 year after the completion of irradiation. Actuarial overall 3 and 5 years survival rate of all 63 Patients were 11.8% and 8.8%, respectively. The actuarial 3 and 5 years survival rates of 17 cases of $T_1$, esophageal cancer were 24.7% and 20.8%. Statistically, there was no significant difference in survival rate according to tumor location (p>0.05). Radical Radiotherapy, Esophageal Cancer

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Immunologic Aspect of Carcinogenesis (발암의 면역학적 관점)

  • 이강대
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.245-252
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    • 1997
  • 실험실에서 면역세포가 종양세포를 죽일 수 있다든가 혹은 드물지만 암 환자에서 암이 자연적으로 소실되었다는 임상적 보고 그리고 AIDS 환자와 같은 면역계의 장애를 가진 환자에서 Kaposi 육종, 특정 형태의 림프종이 더 잘 생긴다는 것 등으로 미루어 보면 동물이나 인간에 발생하는 암에 대해 어느 정도의 면역반응이 일어나는 것은 분명하다. 인체는 규칙적으로 암세포를 생산하지만 면역계에 의해 제거되는 것으로 추측된다. 그러나 아직도 면역계가 어떻게 암을 억제하는지 그리고 면역계가 암발생을 억제하는데 왜 실패하는지에 대해서는 정확히 모르고 있다. 이러한 의문점들은 앞으로 종양 면역학이 규명해야 할 과제이다.

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Results of Radiation Therapy for Squamous Cell Carcinoma of the Esophagus (식도 편평세포암의 방사선치료 결과)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.10-14
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    • 2009
  • Purpose: This study was designed to evaluate the effectiveness and prognostic factors for patients treated with postoperative radiation therapy following surgery or with radiation therapy alone for squamous cell carcinoma of the esophagus. Materials and Methods: We retrospectively analyzed 132 esophageal cancer patients treated with postoperative radiation therapy following surgery or patients who were treated with radiation therapy alone at our institution from 1989 to 2006. Thirty-five patients had stage II disease, 88 patients had stage III disease and nine patients had stage IV disease. Tumors were located at the upper esophagus in 18 patients, the mid esophagus in 81 patients and the distal esophagus in 33 patients. Sixty patients were treated with radiation therapy alone and 72 patients were treated with postoperative radiation therapy following surgery. Eight patients received a dose less than 40 Gy and 78 patients received a dose of 40 to 50 Gy. The remaining 46 patients received a dose of 50 to 60 Gy. The majority of patients who underwent postoperative radiation therapy received a dose of 45 Gy. Results: Actuarial survival rates for all of the patients at two years and five years were 24% and 5%, respectively. The median survival time was 11 months. Survival rates for patients who underwent postoperative RT at two years and five years were 29% and 8%, respectively. The corresponding survival rates for patients who received radiation alone were 18% and 2%, respectively. Survival rates at two years and five years were 43% and 15% for stage II disease, 22% and 2% for stage III disease and 0% and 0% for stage IV disease, respectively; these findings were statistically significant. Two-year survival rates for patients with upper, middle and distal esophageal cancer were 19, 29% and 22%, respectively. Although there was a trend of slightly better survival for middle esophageal tumors, this finding was not statistically significant. Complete response to radiation was achieved in 13 patients (22%) and partial response to radiation was achieved in 40 patients (67%) who received radiation alone. No response to radiation was noted in seven patients (12%). A statistically significant difference in survival rates was seen between patients that had a complete response and patients that had a partial response. Two-year survival rates for patients that had a complete response versus patients that had a partial response were 31% and 17%, respectively. There were no survivors for patients with no response as determined at two-year follow-up. Conclusion: We conclude that radiation therapy is an effective treatment for esophageal cancer. Stage and response to radiation therapy were noted to be prognostic factors. A more effective treatment modality is needed to improve long term survival because of the relatively dismal prognosis for this tumor.

식도암

  • Kim, Chung-Bae
    • 건강소식
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    • v.20 no.11 s.216
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    • pp.12-13
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    • 1996
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