Second Primary Cancer Developing in the Reconstructed Gastric Tube sfter Esophagectomy for Esophageal Cancer: Clinicopathological Analyses of 14 Cases

概要

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Background and Objectives : To clarify the clinicopathologic features and determine the adequate management of a second primary carcinoma developing in the reconstructed gastric tube (CRGT) after esophagectomy for esophageal cancer, clinical and pathological records of 14 patients with CRGT were reviewed. Methods : A total of 14 cases of CRGT were divided into 9 cases of early (T1) CRGT and 5 cases of advanced (T2 or more extensive) CRGT according to the depth of tumor invasion. Results : All of the 9 patients with early CRGT were asymptomatic, and the cancer was detected on follow-up endoscopic examination, whereas 4 of the 5 patients with advanced CRGT presented symptoms. The majority of the patients with early CRGT were treated by means of endoscopic mucosal resection with or without a combination of laser ablation or partial resection of the gastric tube. The 5-year survival rate for patients with early CRGT was 71%, whereas none of the patients with advanced CRGT survived more than one year, regardless of the type of treatment. There was a significant difference (P=0.0014) between the survival curves for the two patient groups. Conclusions : Postoperative endoscopic examination may be useful for the early detection and favorable treatment results in patients with CRGT after esophageal replacement for esophageal cancer.
新潟大学の論文