特集名 | 食道癌治療 -- 最近の話題 | |
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題名 | m3・sm1食道癌の外科治療 -- リンパ節転移の解析からみた治療法の選択 | |
発刊年月 | 2003年 10月 | |
著者 | 梶山 美明 | 順天堂大学医学部食道・胃外科 |
著者 | 鶴丸 昌彦 | 順天堂大学医学部食道・胃外科 |
著者 | 岩沼 佳見 | 順天堂大学医学部食道・胃外科 |
著者 | 富田 夏実 | 順天堂大学医学部食道・胃外科 |
著者 | 天野 高行 | 順天堂大学医学部食道・胃外科 |
【 要旨 】 | m3・sm1食道癌のリンパ節転移率は約20%であり,リンパ節転移部位も反回神経周囲リンパ節と,噴門部周囲リンパ節に高率に認められ進行食道癌と同様であった.また転移リンパ節の約2/3では転移巣の大きさは5mm未満と微小であり,術前のリンパ節転移診断を100%正確に行いえない現状ではm3・sm1食道癌に対するもっとも確実な治療法は手術による病巣およびリンパ節の的確な除去であると考えられる.m3・sm1食道癌の転移リンパ節個数は数個以内と少数であり高い根治性が望めるだけに,リンパ節郭清手術の精度や術後合併症率を含めたqualityの高い手術が要求される. |
Theme | Current Topics on The Treatment for Esophageal Cancer | |
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Title | Surgery for m3•m1 Esophageal Cancer: Treatment Strategy Based on the Analysis of Lymph Node Metastasis | |
Author | Yoshiaki Kajiyama | Department of Surgery Juntendo University, School of Medicine |
Author | Masahiko Tsurumaru | Department of Surgery Juntendo University, School of Medicine |
Author | Yoshimi Iwanuma | Department of Surgery Juntendo University, School of Medicine |
Author | Natsumi Tomita | Department of Surgery Juntendo University, School of Medicine |
Author | Takayuki Amano | Department of Surgery Juntendo University, School of Medicine |
[ Summary ] | The rate of lymph node metastasis in m3•sm1 esophageal cancer was almost 20%. Metastatic lymph nodes in m3•sm1 esophageal cancer were frequently found both along the recurrent laryngeal nerve and around the gastric cardia, as well as in advanced esophageal cancer. The pathologic diameters of metastasis in the lymph nodes of esophageal cancer cases were less than 5mm in almost two thirds of all metastatic nodes. Preoperative diagnosis of lymph node metastasis is not possible with 100% precision. Currently the most reliable method of treatment for m3•sm1 esophageal cancer is esophagectomy, with precise lymph node dissection. The number of lymph node metastasis in the m3•m1 range with esophageal cancer was low, and we can cure these esophageal cancers with accurate lymph node dissection, resulting in a low rate of postoperative morbidity and mortality. In the treatment of m3•sm1 esophageal cancer, quality assurance for surgical procedures is essential. |