A case involving long-term survival after esophageal cancer with liver and lung metastases treated by multidisciplinary therapy: report of a case
A case involving long-term survival after esophageal cancer with liver and lung metastases treated by multidisciplinary therapy: report of a case
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DOI：
10.1007/s00595-012-0240-7
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发表时间：
2013-05-01
期刊：
影响因子：
2.5
通讯作者：
Otsuji, Eigo
中科院分区：
文献类型：
--
作者：
Iitaka, Daisuke;Shiozaki, Atsushi;Otsuji, Eigo
一名 57 岁男性患有下段食管癌，接受了食管次全切除术和淋巴结清扫术。组织病理学诊断为低分化鳞状细胞癌，pT2N1M0 pStageIIB。经过一个疗程的低剂量 CDDP/5FU 术后辅助化疗后，术后 12 个月进行的 PET-CT 扫描显示 S2 区有孤立性肝转移。随后，患者接受了 5 个疗程的多西他赛化疗（80 毫克/人，每三周），并观察到部分缓解。我们还进行了射频消融 (RFA)，之后观察到了完整的反应。术后二十个月，我们在同一位置检测到局部肝脏复发，并进行了额外的 RFA。手术后 24 个月，在左侧 S2 区检测到孤立性肺转移，患者又接受了 5 个疗程的多西紫杉醇治疗。随后，PET-CT 显示肺部和肝脏肿瘤生长，其他部位没有复发。手术后二十九个月，我们部分切除了转移性肝脏和肺部肿瘤，此后没有检测到后续复发。众所周知，食管癌器官复发患者的预后极差，并且尚未建立治疗这些患者的最佳治疗策略。这一长期生存病例表明，多学科治疗对于食管切除术后肝肺复发的治疗是有效的。
A 57-year-old male with lower esophageal cancer underwent subtotal esophagectomy with lymphadenectomy. The histopathological diagnosis was poorly differentiated squamous cell carcinoma, pT2N1M0 pStageIIB. After one course of postoperative adjuvant chemotherapy involving low-dose CDDP/5FU, a PET-CT scan obtained 12 months after surgery revealed a solitary liver metastasis in the S2 area. The patient then underwent five courses of docetaxel chemotherapy (80 mg/body, tri-weekly), and a partial response was observed. We also performed radiofrequency ablation (RFA), after which a complete response was observed. Twenty months after surgery, we detected local liver recurrence in the same position and performed additional RFA. Twenty-four months after surgery, a solitary lung metastasis was detected in the left S2 area and the patient was administered five additional courses of docetaxel therapy. Subsequently, PET-CT revealed growth of lung and liver tumors without recurrence in other areas. Twenty-nine months after surgery, we partially excised metastatic liver and lung tumors, and no subsequent recurrence has since been detected. The prognoses of patients who suffer from esophageal cancer organ recurrence are known to be extremely poor, and optimal therapeutic strategies for treating these patients have not been established. This long-term survival case suggests that multidisciplinary therapy for the treatment of liver and lung recurrence after esophagectomy is effective.