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外科或放疗是难于治愈食管癌的,大多数报告五年生存率小于5%,但是经严格选择的外科治疗五年生存率高达25%。颈和纵隔淋巴结的外科清扫术其价值有限,本文拟说明鳞状细胞食管癌切除术后继发颈和纵隔淋巴结转移的治疗。作者自61年10月至77年12月对132例食管癌作了切除术,病人年龄36～74岁,中位年龄为60。肿瘤分类以鳞癌为主120例,12例为不常见的类型如燕麦细胞癌和囊性腺癌。91例鳞癌作了食管根治切除术和29例姑息切除。91例中9例术后生存不到一个月。手术死亡率为10%,其余82例,仅5例接受术前放疗,34例发生了继发的颈和纵隔淋巴结转移,其中18例进行了放疗。
Surgical or radiotherapy is difficult to cure esophageal cancer, and most reports have a five-year survival rate of less than 5%, but the five-year survival rate for surgical treatment with strict selection is as high as 25%. Surgical dissection of cervical and mediastinal lymph nodes is of limited value. This article is intended to describe the treatment of secondary cervical and mediastinal lymph node metastases after excision of squamous cell carcinoma of the esophagus. The authors performed resection of 132 cases of esophageal cancer from October 61 to December 77. The patient’s age ranged from 36 to 74 years and the median age was 60. Tumor classification was based on 120 cases of squamous cell carcinoma and 12 cases were uncommon types such as oat cell carcinoma and cystic adenocarcinoma. 91 cases of squamous cell carcinoma underwent esophageal radical resection and 29 cases of palliative resection. Nine out of 91 cases survived less than one month after surgery. The operative mortality rate was 10%, and the remaining 82 patients received radiotherapy only in 5 cases, secondary cervical and mediastinal lymph node metastases occurred in 34 cases, and 18 cases received radiotherapy.