下咽頭・頸部食道癌に対する治療方針とその成績

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タイトル別名
  • Treatment Policy and the Results of Therapy of Cancers Localized in the Hypopharynx and the Cervical Esophagus
  • シタ イントウ ・ ケイブ ショクドウガン ニ タイスル チリョウ ホウシン ト ソノ セイセキ--カコ 5ネンカン ノ イチジ チリョウレイ,42 ショウレイ ノ マトメ
  • 過去5年間の一次治療例, 42症例のまとめ

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Forty two cases of cancers localized in the hypopharynx and the cervical esophagus, which we have treated in the past five years, were presented and discussed here in this paper with special reference to our treatment policy and the results. Conclusions are as follows;<BR>1. According to the UICC classification, the 92 cases are composed of 4 T1, 17 T2 and 21 T3 cases, including 3 far advanced cases.<BR>2. A carefully planned clinical program of combined pre-operative radiation and chemotherapy has been conducted for all cases. A guidance how to select an approach for resection of the tumor depending cn the degree of invasion and to reconstruct the defect was shown.<BR>3. Se, eral factcrs which are essential to a safer treatment were emphasized, including a proper handling of the recurrent laryngeal nerve, resection of the thyroid and parathyroid glands, problems in the post-operative care and so on.<BR>4. Following up of these 42 cases has been conducted through October 1, 1977. As of that date, 26 patients were alive with no evidence of cancer, while 16 patients had died. Ten were surviving more than 3 years and 2 of them more than 5 years. All of these survivors have well been controled by the primary therapy but one who had been treated secondarily for a local recurrent lesion.<BR>5. All of T1 cases are susviving, while about a half of T2 and T3<BR>6. All of death but one occured within 6 months after the surgery.<BR>7. Five patients were died of cancer and 2 of them from distant metastasis, which is less than those of intercurrent causes.<BR>8. Twelve of 18 patients who were treated by partial hypopharyngectomy with preservation of the larynx are alive with no evidence of cancer, which indicates a wide field resection is not nec- cessarily essential to radical resection of the tumor.<BR>9. Radical neck dissection was performed for all cases but one. Twenty nine (69%) cases showed pathohistologically positive nodes and had poorer prognosis than the negative cases.<BR>10. Contralateral neck metastasis cccurred in none of these 26 survivors up to that date.

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