摘要
目的探究新辅助化疗后食管鳞癌残存淋巴结转移规律以及影响淋巴结转移的危险因素。方法收集2014年1月至2017年12月在复旦大学附属肿瘤医院胸外科进行手术的食管癌患者临床资料,通过分析188例术前接受新辅助化疗且术后病理为鳞癌的患者病理资料探究其化疗后残存淋巴结转移规律以及影响淋巴结转移的危险因素。结果对于接受过新辅助化疗的食管鳞癌患者,颈部、全纵隔以及腹部淋巴结转移比例均较高。原发肿瘤位置、有无神经侵犯以及是否接受过新辅助放疗是影响残存淋巴结转移的独立危险因素。结论对接受过新辅助化疗的食管鳞癌患者宜进行3野淋巴结清扫,清扫时需重点清扫食管旁淋巴结、锁骨上淋巴结、气管旁淋巴结和胃周淋巴结。
Objective The aim of this study is to explore the distribution of residual lymph node metastases(LNM) in esophageal squamous cell carcinoma(ESCC) after neoadjuvant chemotherapy, and identify risk factors related to LNM. Methods The clinical data of patients who underwent esophagectomy from January 2014 to December 2017 in Fudan University Shanghai Cancer Center were collected. The pathological data of all 188 patients with ESCC who underwent esophagectomy after neoadjuvant chemotherapy were retrospectively studied. The risk factors of LNM were analyzed. Results In general, cervical region, mediastinum and abdomen were all areas in which LNM occurred frequently in patients with ESCC after neoadjuvant chemotherapy. Tumor location(P=0.012), nerve invasion(P=0.018) and neoadjuvant radiotherapy(P=0.001) were the independent risk factors of LNM. Conclusions 3-field lymphadenectomy for patients with ESCC who accepted neoadjuvant chemotherapy is suggested. The paraesophageal lymph nodes, supraclavicular lymph nodes, paratracheal lymph nodes and perigastric lymph nodes should be focused in the lymphadenectomy.
作者
叶巍
相加庆
YE Wei;XIANG Jiaqing(Department of Thoracic Surgery,Fudan University Shanghai Cancer Center,Shanghai 200030,China)
出处
《中国肿瘤外科杂志》
CAS
2021年第4期345-351,共7页
Chinese Journal of Surgical Oncology
关键词
食管鳞癌
新辅助化疗
淋巴结转移
颈部淋巴结转移
3野清扫
Esophageal squamous cell carcinoma
Neoadjuvant chemotherapy
Lymph node metastasis
Cervical lymph node metastasis
3-field lymphadenectomy
