<原著>切除後1年以内に死亡した食道粘膜下層浸潤癌症例の検討

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The aim of this study was to clarify the clinicopathological features of patients with esophageal cancer confined to the submucosa (EC-sm) who died within one year after esophagectomy. Between 1970 and 1999,107 patients with EC-sm underwent esophagectomy in The Department Surgery, Niigata University. Of these patients, 17 (16%) died within one year after esophagectomy (Group A) and 90 survived over one year after esophagectomy (Group B). Preoperative organ function, operative procedure, postoperative complication, pathological data, and cause of death were examined retrospectively. The cause of death (recurrent esophageal cancer vs. other diseases) was not different between the two groups. In patients who died of recurrent esophageal cancer, patients with undifferentiated carcinoma (43%) and patients who died of hematogenic metastasis (57%) were significantly more common in Group A than those in Group B (6% and 13%, respectively). In patients who died of unrelated diseases, patients having postoperative complication especially pulmonary complication (60%) and patients who died of pneumonia (50%) were significanctly more common in Group A than those in Group B. In conclusion, to decrease the frequency of early death especially within one year after esophagectomy for EC-sm, multimodality treatment including chemo-radiotherapy as well as surgery for patient with undifferentiated carcinoma and the detection of patients with inapparent systemic spread may be needed. Furthermore, careful operative manipulation as well as meticulous pre-and post operative managiment is also important.
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<原著>切除後1年以内に死亡した食道粘膜下層浸潤癌症例の検討

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