从外科视角看可切除颈段食管癌的治疗

Treatment for resectable cervical esophageal carcinoma:A surgical perspective

从保留器官的角度考虑,根治性放化疗是目前治疗颈段食管癌的首选方案。然而根治性放化疗治疗颈段食管癌的远期效果并不令人满意。单纯的外科手术治疗颈段食管癌的远期疗效并不明显优于根治性放化疗。颈段食管癌的外科治疗往往要联合喉切除,影响患者的生活质量。近年来的证据表明,新辅助治疗联合手术治疗颈段食管癌,其远期生存更佳。另一方面,保喉手术、微创食管切除手术等技术的发展,降低了手术风险,提高了患者生活质量。本文将从外科视角,综述颈段食管癌综合治疗的新进展。

Definitive chemoradiotherapy(dCRT)is the general recommendation for the treatment of cervical esophageal cancer for organ preservation.However,the long-term survival of dCRT is not satisfactory.Surgical resection alone is not superior to dCRT in the treatment of cervical esophageal cancer.Surgical resection is often combined with laryngectomy,which will affect the quality of life.Recent evidence suggests that neoadjuvant therapy combined with surgery improves the long-term survival of cervical esophageal cancer.On the other hand,the development of technologies such as laryngeal preservation surgery and minimally invasive esophagectomy has reduced the risk of operation and improved the quality of life.This article will review the new progress in the comprehensive treatment of cervical esophageal cancer from the perspective of surgery.