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Purpose : The purpose of this study was to clarify the outcomes of preoperative CDDP/5-FU chemotherapy (FP therapy) followed by surgery for patients with clinical Stage II/III thoracic esophageal canc...er. Methods : Seventeen patients with clinical Stage II/III thoracic esophageal cancer who underwent FP therapy followed by esophagectomy were investigated with regard to the perioperative clinical results and postoperative outcomes. Results : Grade 3 or 4 adverse effects associated with FP therapy were recognized in 2 of the 17 (11.8%) cases, and 16 patients completed 2 cycles of FP therapy (94.1%). Complications after surgery occurred in 7 cases (41.2%). There were 7 patients with postoperative recurrences (41.2%), 6 of whom had clinical Stage III disease. Similarly, 4 out of the 5 patients who died of cancer had clinical Stage III disease. All recurrences and cancer-related deaths were recognized in histological effectiveness of Grade 0/1 cases. Conclusions : Preoperative FP therapy was found to be safe for patients with clinical Stage II/III thoracic esophageal cancer. However, the treatment seemed to be less beneficial for Stage III patients than for Stage II patients, thus suggesting that a more powerful preoperative treatment may be necessary for clinical Stage III patients.
【目的】CDDP/5-FU(FP療法)を用いた術前化学療法(NAC)後，手術を施行したcStageII/III胸部食道癌症例の転帰について明らかにすることである．【方法】当科でFP療法後に食道切除術が施行された胸部食道癌症例17例の周術期治療成績および術後転帰について調査した．【結果】Grade3/4のNAC関連副作用を2例(11.8％)に認めたが，16例(94.1%)で2サイクルのNACを完遂出来た．術後合併症は7例(41.2%)に認めた．術後7例(41.2%)に再発を認め，その内6例がcStageIIIであり，5例認めた癌死の内4例がcStageIIIであった．また，すべての再発・癌死例は，術後病理所見による治療効果判定がGrade0/1症例であった．【考察】FP療法は安全な治療法であるが，その効果はcStageII症例に比べcStageIII症例では弱いように思われ，cStageIII症例はより強力な術前治療が必要と考えられた．続きを見る
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