食道cancer boardに基づく統合的治療戦略決定による前向きデータベースを用いた食道扁平上皮癌の予後の検討
目的：当院特有の食道癌治療は，cStage II/III（cT4除く）症例に対するdocetaxel/CDDP/5-FUを用いた術前化学療法，cT4あるいはcM1 lymph node metastasis症例に対するdocetaxel/CDDP/5-FUを用いた化学放射線療法の施設臨床研究からなる．Cancer board（以下，CBと略記）に基づく食道癌治療戦略の決定と最新の予後解析について報告する．方法：2009年1月から2016年3月までに食道CBで検討された504例の食道扁平上皮癌の前向きデータベースに基づく予後解析を行った．結果：（1）手術治療症例のcStage 毎（I/IIA/I...
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| Published in | 日本消化器外科学会雑誌 Vol. 50; no. 12; pp. 941 - 955 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本消化器外科学会
2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2016.0183 |
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| Abstract | 目的：当院特有の食道癌治療は，cStage II/III（cT4除く）症例に対するdocetaxel/CDDP/5-FUを用いた術前化学療法，cT4あるいはcM1 lymph node metastasis症例に対するdocetaxel/CDDP/5-FUを用いた化学放射線療法の施設臨床研究からなる．Cancer board（以下，CBと略記）に基づく食道癌治療戦略の決定と最新の予後解析について報告する．方法：2009年1月から2016年3月までに食道CBで検討された504例の食道扁平上皮癌の前向きデータベースに基づく予後解析を行った．結果：（1）手術治療症例のcStage 毎（I/IIA/IIB/III/IV）の5年全生存率は，88.3/85.2/83.8/55.8/66.7%であった．（2）cStage I/IIB症例に対する手術治療例においては，5年疾患特異的生存率は95.3/90.2%と極めて良好であった．cStage IIBでは90.5%の症例に術前化学療法が施行された．（3）cStage IIA/III症例の手術治療成績は，予後不良のcT4症例を除いた非手術治療と比較して有意に良好であった（P=0.0229）．（4）遠隔転移cStage IV症例の長期生存例は，傍大動脈リンパ節転移例に対するconversion surgeryであった．結語：食道CBによる集学的治療方針決定により予後が最適化された．特に手術治療症例の予後が良好であり，適応患者には最も推奨できる治療法と考える． |
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| AbstractList | 目的：当院特有の食道癌治療は，cStage II/III（cT4除く）症例に対するdocetaxel/CDDP/5-FUを用いた術前化学療法，cT4あるいはcM1 lymph node metastasis症例に対するdocetaxel/CDDP/5-FUを用いた化学放射線療法の施設臨床研究からなる．Cancer board（以下，CBと略記）に基づく食道癌治療戦略の決定と最新の予後解析について報告する．方法：2009年1月から2016年3月までに食道CBで検討された504例の食道扁平上皮癌の前向きデータベースに基づく予後解析を行った．結果：（1）手術治療症例のcStage 毎（I/IIA/IIB/III/IV）の5年全生存率は，88.3/85.2/83.8/55.8/66.7%であった．（2）cStage I/IIB症例に対する手術治療例においては，5年疾患特異的生存率は95.3/90.2%と極めて良好であった．cStage IIBでは90.5%の症例に術前化学療法が施行された．（3）cStage IIA/III症例の手術治療成績は，予後不良のcT4症例を除いた非手術治療と比較して有意に良好であった（P=0.0229）．（4）遠隔転移cStage IV症例の長期生存例は，傍大動脈リンパ節転移例に対するconversion surgeryであった．結語：食道CBによる集学的治療方針決定により予後が最適化された．特に手術治療症例の予後が良好であり，適応患者には最も推奨できる治療法と考える． |
| Author | 渡邊, 昌彦 山下, 継史 原田, 宏輝 森谷, 宏光 堅田, 親利 細田, 桂 鷲尾, 真理愛 小森, 承子 三重野, 浩朗 江間, 玲 |
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| References | 10) Kurokawa Y, Muto M, Minashi K, Boku N, Fukuda H. A phase II trial of combined treatment of endoscopic mucosal resection and chemoradiotherapy for clinical stage I esophageal carcinoma: Japan Clinical Oncology Group Study JCOG0508. Jpn J Clin Oncol. 2009;39(10):686–689. 9) 小山 恒男，宮田 佳典，島谷 茂樹，友利 彰寿，堀田 欣一，吉田 操．【食道m3・sm1癌の診断と遠隔成績】第46回食道色素研究会アンケート調査報告 転移のあったm3・sm1食道癌の特徴．胃と腸．2002;37(1):71–74. 3) Kachnic LA, Winter K, Wasserman T, Kelsen D, Ginsberg R, Pisansky TM, et al. Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): a phase III trial of definitive chemoradiotherapy for esophageal cancer. Gastrointest Cancer Res. 2011;4(2):45–52. 20) Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88:890–899. 19) Yamashita K, Hosoda K, Moriya H, Katada C, Sugawara M, Mieno H, et al. Prognostic advantage of docetaxel/cisplatin/5-fluorouracil neoadjuvant chemotherapy in clinical stage II/III esophageal squamous cell carcinoma due to excellent control of preoperative disease and postoperative lymph node recurrence. Oncology. 2017;92(4):221-228. 7) Mizuta H, Nishimori I, Kuratani Y, Higashidani Y, Kohsaki T, Onishi S, et al. Predictive factors for esophageal stenosis after endoscopic submucosal dissection for superficial esophageal cancer. Dis Esophagus. 2009;22:626–631. 16) Katada N, Yamashita K, Katada C, Moriya H, Hosoda K, Mieno H, et al. Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis. Esophagus. 2014;11:173–181. 4) Higuchi K, Komori S, Tanabe S, Katada C, Azuma M, Ishiyama H, et al. Definitive chemoradiation therapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) in advanced esophageal cancer: a phase 2 trial (KDOG 0501-P2). Int J Radiat Oncol Biol Phys. 2014;89(4):872–879. 21) Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81(3):684–690. 23) Ishida K, Ando N, Yamamoto S, Ide H, Shinoda M. Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG)/Japan Clinical Oncology Group trial (JCOG9516). Jpn J Clin Oncol. 2004;34:615–619. 17) Sugawara M, Katada C, Katada N, Takahashi K, Higuchi K, Komori S, et al. Retrospective evaluation of adverse events of neoadjuvantor induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil in esophageal squamous cell carcinoma. Esophagus. 2013;10:65–69. 5) Yamashita K, Katada N, Moriya H, Hosoda K, Sakuramoto S, Kikuchi S, et al. Multimodality treatment and prognosis in esophageal squamous cell carcinoma requiring esophagectomy. Hepatogastroenterology. 2014;61(132):1042–1048. 12) Kato H, Sato A, Fukuda H, Kagami Y, Udagawa H, Toga A, et al. A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol. 2009;39(10):638–643. 11) Muto M, Minashi K, Nihei K, Mizusawa J, Yano T, Ezoe Y, et al. Efficacy of combined endoscopic resection and chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma (ESCC): a single-arm confirmatory study (JCOG0508). Poster session presented at: Gastrointestinal (Noncolorectal) Cancer. Annual Meeting of the American Society of Clinical Oncology; 2016 Jun 3–7; Chicago, Illinois. 8) Katada C, Muto M, Momma K, Arima M, Tajiri H, Kanamaru C, et al. Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae—a multicenter retrospective cohort study. Endoscopy. 2007;39(9):779–783. 18) Yamashita K, Katada N, Moriya H, Hosoda K, Mieno H, Katada C, et al. Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis. Gen Thorac Cardiovasc Surg. 2016;64:209–215. 1) 国立研究開発法人国立がん研究センターがん対策情報センター．国立がん研究センターがん情報サービス「がん登録・統計」．平成28年9月報［Internet］．[updated 2016 Aug 2; cited 2017 Jan 25]. Available from: http://ganjoho.jp/reg_stat/statistics/stat/summary.html. 6) Takahashi H, Arimura Y, Masao H, Okahara S, Tanuma T, Kodaira J, et al. Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc. 2010;72(2):255–264. 15) Fultz PJ, Feins RH, Strang JG, Wandtke JC, Johnstone DW, Watson TJ, et al. Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US. Radiology. 2002;222(1):245–251. 22) Ohtsu A, Boku N, Muro K, Chin K, Muto M, Yoshida S, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–2921. 2) Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74. 13) Akutsu Y, Kato K, Igaki H, Ito Y, Nozaki I, Daiko H, et al. The prevalence of overall and initial lymph node metastases in clinical T1N0 thoracic esophageal cancer: from the results of JCOG0502, a prospective multicenter study. Ann Surg. 2016;264(6):1009–1015. 14) Dorfman RE, Alpern MB, Gross BH, Sandler MA. Upper abdominal lymph nodes: criteria for normal size determined with CT. Radiology. 1991;180(2):319–322. 24) Nishimura Y, Suzuki M, Nakamatsu K, Kanamori S, Yagyu Y, Shigeoka H. Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula. Int J Radiat Oncol Biol Phys. 2002;53:134–139. |
| References_xml | – reference: 6) Takahashi H, Arimura Y, Masao H, Okahara S, Tanuma T, Kodaira J, et al. Endoscopic submucosal dissection is superior to conventional endoscopic resection as a curative treatment for early squamous cell carcinoma of the esophagus (with video). Gastrointest Endosc. 2010;72(2):255–264. – reference: 14) Dorfman RE, Alpern MB, Gross BH, Sandler MA. Upper abdominal lymph nodes: criteria for normal size determined with CT. Radiology. 1991;180(2):319–322. – reference: 2) Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74. – reference: 3) Kachnic LA, Winter K, Wasserman T, Kelsen D, Ginsberg R, Pisansky TM, et al. Longitudinal quality-of-life analysis of RTOG 94-05 (Int 0123): a phase III trial of definitive chemoradiotherapy for esophageal cancer. Gastrointest Cancer Res. 2011;4(2):45–52. – reference: 4) Higuchi K, Komori S, Tanabe S, Katada C, Azuma M, Ishiyama H, et al. Definitive chemoradiation therapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-R) in advanced esophageal cancer: a phase 2 trial (KDOG 0501-P2). Int J Radiat Oncol Biol Phys. 2014;89(4):872–879. – reference: 23) Ishida K, Ando N, Yamamoto S, Ide H, Shinoda M. Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG)/Japan Clinical Oncology Group trial (JCOG9516). Jpn J Clin Oncol. 2004;34:615–619. – reference: 7) Mizuta H, Nishimori I, Kuratani Y, Higashidani Y, Kohsaki T, Onishi S, et al. Predictive factors for esophageal stenosis after endoscopic submucosal dissection for superficial esophageal cancer. Dis Esophagus. 2009;22:626–631. – reference: 15) Fultz PJ, Feins RH, Strang JG, Wandtke JC, Johnstone DW, Watson TJ, et al. Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US. Radiology. 2002;222(1):245–251. – reference: 8) Katada C, Muto M, Momma K, Arima M, Tajiri H, Kanamaru C, et al. Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae—a multicenter retrospective cohort study. Endoscopy. 2007;39(9):779–783. – reference: 22) Ohtsu A, Boku N, Muro K, Chin K, Muto M, Yoshida S, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–2921. – reference: 17) Sugawara M, Katada C, Katada N, Takahashi K, Higuchi K, Komori S, et al. Retrospective evaluation of adverse events of neoadjuvantor induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil in esophageal squamous cell carcinoma. Esophagus. 2013;10:65–69. – reference: 21) Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81(3):684–690. – reference: 1) 国立研究開発法人国立がん研究センターがん対策情報センター．国立がん研究センターがん情報サービス「がん登録・統計」．平成28年9月報［Internet］．[updated 2016 Aug 2; cited 2017 Jan 25]. Available from: http://ganjoho.jp/reg_stat/statistics/stat/summary.html. – reference: 9) 小山 恒男，宮田 佳典，島谷 茂樹，友利 彰寿，堀田 欣一，吉田 操．【食道m3・sm1癌の診断と遠隔成績】第46回食道色素研究会アンケート調査報告 転移のあったm3・sm1食道癌の特徴．胃と腸．2002;37(1):71–74. – reference: 11) Muto M, Minashi K, Nihei K, Mizusawa J, Yano T, Ezoe Y, et al. Efficacy of combined endoscopic resection and chemoradiotherapy for clinical stage I esophageal squamous cell carcinoma (ESCC): a single-arm confirmatory study (JCOG0508). Poster session presented at: Gastrointestinal (Noncolorectal) Cancer. Annual Meeting of the American Society of Clinical Oncology; 2016 Jun 3–7; Chicago, Illinois. – reference: 19) Yamashita K, Hosoda K, Moriya H, Katada C, Sugawara M, Mieno H, et al. Prognostic advantage of docetaxel/cisplatin/5-fluorouracil neoadjuvant chemotherapy in clinical stage II/III esophageal squamous cell carcinoma due to excellent control of preoperative disease and postoperative lymph node recurrence. Oncology. 2017;92(4):221-228. – reference: 12) Kato H, Sato A, Fukuda H, Kagami Y, Udagawa H, Toga A, et al. A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol. 2009;39(10):638–643. – reference: 20) Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88:890–899. – reference: 10) Kurokawa Y, Muto M, Minashi K, Boku N, Fukuda H. A phase II trial of combined treatment of endoscopic mucosal resection and chemoradiotherapy for clinical stage I esophageal carcinoma: Japan Clinical Oncology Group Study JCOG0508. Jpn J Clin Oncol. 2009;39(10):686–689. – reference: 16) Katada N, Yamashita K, Katada C, Moriya H, Hosoda K, Mieno H, et al. Neoadjuvant chemotherapy using concurrent Docetaxel/CDDP/5-FU (DCF) in esophageal squamous cell carcinoma and its short-term prognosis. Esophagus. 2014;11:173–181. – reference: 5) Yamashita K, Katada N, Moriya H, Hosoda K, Sakuramoto S, Kikuchi S, et al. Multimodality treatment and prognosis in esophageal squamous cell carcinoma requiring esophagectomy. Hepatogastroenterology. 2014;61(132):1042–1048. – reference: 13) Akutsu Y, Kato K, Igaki H, Ito Y, Nozaki I, Daiko H, et al. The prevalence of overall and initial lymph node metastases in clinical T1N0 thoracic esophageal cancer: from the results of JCOG0502, a prospective multicenter study. Ann Surg. 2016;264(6):1009–1015. – reference: 18) Yamashita K, Katada N, Moriya H, Hosoda K, Mieno H, Katada C, et al. Neoadjuvant chemotherapy of triplet regimens of docetaxel/cisplatin/5-FU (DCF NAC) may improve patient prognosis of cStage II/III esophageal squamous cell carcinoma-propensity score analysis. Gen Thorac Cardiovasc Surg. 2016;64:209–215. – reference: 24) Nishimura Y, Suzuki M, Nakamatsu K, Kanamori S, Yagyu Y, Shigeoka H. Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula. Int J Radiat Oncol Biol Phys. 2002;53:134–139. |
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| Title | 食道cancer boardに基づく統合的治療戦略決定による前向きデータベースを用いた食道扁平上皮癌の予後の検討 |
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| ispartofPNX | 日本消化器外科学会雑誌, 2017/12/01, Vol.50(12), pp.941-955 |
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