对于整个周边cT1aN0M0食道状细胞癌的内镜下膜剖析后的长期结果
Atsushi Inaba1, Tomohiro Kadota1, Keiichiro Nishihara2
1Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East.
Gastrointestinal endoscopy
|January 31, 2026
概括
对于周围食道状细胞癌 (ESCC) 的内镜下粘膜剖析 (ESD) 显示出有希望的生存率,但具有高食道狭窄的风险. 需要进一步的研究来完善这些病变的ESD指示.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 手术瘤学手术瘤学
背景情况:
- 内镜下粘膜切割 (ESD) 是早期食道癌的标准,但由于狭窄风险,其在周围病变中的使用仍在争论中.
- 目前对周边cT1aN0M0ESCC的治疗选择各不相同,长期结果不清楚.
研究的目的:
- 为了比较ESD的长期结果,食管切除术和周围cT1aN0M0 ESCC的化学放射治疗.
- 为了评估生存率,狭窄的发展,以及在不同方式的治疗疗效.
主要方法:
- 在2010年至2018年期间接受治疗的59名周边cT1aN0M0ESCC患者的回顾性分析.
- 五年总生存率 (OS),无病生存率 (DFS),食道狭窄率和完全响应率的比较.
主要成果:
- 在ESD组 (28名患者) 显示5年OS/DFS为93%/89%. 消化管切除 (16名患者) 的5年OS/DFS为87%/87%. 化疗放射治疗 (15名患者) 的5年OS/DFS为75%/69%.
- 在ESD中,食道狭窄率 (79%) 和耐火性狭窄率 (46%) 高. 消化管切除术的发生率较低 (20%/13%). 化学辐射疗法没有收缩,但与治愈性ESD切除 (72%) 相比,完全响应率较低 (94%).
结论:
- 对于周边cT1aN0M0ESCC的长期结果因治疗方式而异.
- 与食道切除术和化疗放射治疗相比,ESD与更高的食道和耐火性狭窄率有关.
- 需要进行进一步的大规模研究,以确定ESD在这些特定情况下的准确指示标准.
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