| 特集名 | 早期食道癌 -- 病型分類と深達度から | |
|---|---|---|
| 題名 | 早期食道癌の予後 (2) 病型分類と深達度からみた早期食道癌の予後 | |
| 発刊年月 | 1997年 11月 | |
| 著者 | 幕内 博康 | 東海大学医学部外科 |
| 著者 | 島田 英雄 | 東海大学医学部外科 |
| 【 要旨 】 | 病型分類と深達度から食道表在癌の予後を検討した． 食道表在癌で外科的切除術を行った133例の5年生存率は85.6%であり，早期癌67例では95.4%であった． 深達度別に食道表在癌の5生率をみると粘膜上皮(m1)から粘膜下層表層(sm1)では100%であり，sm2,sm3では72~73%であった． 病型分類別にみると，深達度を反映し0-IIa,0-IIb型は100%，粘膜下層癌を混ずる0-IIc型は94.4%，ほとんど粘膜下層癌である0-I型と0-III型はそれぞれ77.5%，72.2%であった． EMRの5生率は100%であった． 食道癌の早期診断，とくに粘膜癌の発見が，予後の面のみならずQOLの面からも重要である． |
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| Theme | Early Esophageal cancer-from the Viewpoint of its Type and the Depth of Invasion | |
|---|---|---|
| Title | Prognosis of Early Esophageal Cancer -- From the Aspects of Clinical Classification and Depth of Invasion | |
| Author | Hiroyasu Makuuchi | Department of Surgery, Tokai University, School of Medicine |
| Author | Hideo Shimada | Department of Surgery, Tokai University, School of Medicine |
| [ Summary ] | Outcomes of early esophageal cancer were investigated from the aspects of clinical classification and invasive depth. The five year survival rate of superficial esophageal cancer patients treated with radical surgical resection was 85.6%. As for early esophageal cancer, which is limited to within the submucosal layer and has no lymph node metastasis, the rate was 95.4%. If the tumor is limited to within the mucosal layer and the shallow layer of the submucosa, the prognosis is excellent, 100% survival. When the tumor invades to the middle 1/3 or deeper 1/3 of the submucosa, it is poor, 73.5% and 71.6%, respectively. As to clinical classification, 0-IIb and 0-IIa type had a good prognosis with a 100% 5 year survival rate, because the invasive depths of these types of cancer are mucosal, and 0-IIc type, containing mucosal and submucosal carcinoma, a 94.4% 5 year survival rate. The 0-I and 0-III types had a poor prognosis, 77.5% and 72.2%, respectively, because they invaded to the submucosal layer. Endoscopic mucosal resection is indicated for early esophageal cancer, especially mucosal cancer. The outcome of 126 EMR cases was acceptable (100%). Early diagnosis of esophageal cancer, especially mucosal cancer, by endoscopic examination with iodine staining is extremely important not only for determining prognosis but also for the quality of life of patients. |
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