Great Improvement of Survival of Surgical Treatment for Esophageal Cancer.
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概要
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For 25 years ago, we have been performing to the several multidisciplinary treatment for patients with esophageal cancer.15 years ago, we had stopped the preoperative radiotherapy for patients with operable esophageal cancer because the postoperative radiotherapy had shown a higher survival rate than pre-and postoperative radiotherapy reported in prospective randomized trial by Japanese Esophageal Oncology Group (JEOG).Thereafter, we had performed the study of a comparison chemotherapy and radiotherapy as an adjuvant treatment to surgery for esophageal cancer by JEOG'S trial. However, there was no significant difference between chemotherapy and radiotherapy in survival up to 5 years.On the other hand, the area of lymph node dissection in surgical treatment for esophageal cancer have been changed that the dissected area became wide. specially it was important to dissect the lymph nodes around the right and left recurrent laryngeal nerve.According to perfomed the extensive lymph node dissection, the postoperative 5-years survival of esophageal cancer was improved to 50%, To prove the improvement of postoperative survival rate by extensive lymph node dissection, we performed the examination of micrometastasis in esophageal cancer. The examination for micrometastasis had two methods, one was examining the extranodal lymphatic vessel permiation (Exn-LV-Pm) in fibrofatty tissue around dissected lymph nodes, and the other performed study of the tumorgenecity of cancer cells in lymph fluid gathered from thoracic duct by cannulation during the operation.We investigated that positive rate of Exn-LV-Pm was 31.2%, and implantable rate into nude mice of cancer cells was 61.8%.We have to receganize that the micrometastasis is important target to treat patients with esophageal cancer. In conclusion, the development of anticancer agent targetting to cancer cells in lymph fluid is needed to improve the postoperative survival for patients with esophageal cancer.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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