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Adenocarcinoma of the esophagus and/or gastric cardia 总被引:8,自引:0,他引:8
One hundred twenty-nine adenocarcinomas involving the esophagus and/or gastric cardia differed significantly from 212 cancers of the rest of the stomach as follows: male-female ratio, 6:1 versus 2:1, birth outside Canada, US or UK, 12% versus 34%; parent or sibling with gastric cancer, 5% versus 13%; previous duodenal ulcer, 23% versus 9%; chronic reflux symptoms, 25% versus 3%; hiatal hernia, 51% versus 11%. Of the 129 esophagocardia cancers, 24 involved the esophagus alone, 48 the cardia and esophagus, 33 the cardia alone or cardia and fundus, and 24 the upper stomach and lower esophagus extensively. Thirty-four were associated with Barrett's esophagus. The 72 patients with involvement of both the upper stomach and lower esophagus (48 cardia and esophagus, 24 extensive) were identical with the esophagocardia group as a whole. The 24 patients with esophageal cancer and the 34 with Barrett's epithelium were the same clinically as the whole esophagocardia group except more had chronic reflux and hiatal hernia. The 33 patients with cancer confined to the cardia or cardia and fundus resembled the whole esophagocardia group but did not have Barrett's esophagus. Adenocarcinoma of the esophagocardia region is probably a different disease from cancer of the rest of the stomach. 相似文献
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保留喉功能的非开胸食管拔脱颈段食管癌切除术 总被引:5,自引:0,他引:5
目的 探讨保留喉功能的非开胸食管拔脱切除颈段食管癌及胃上提、结肠上徙代食管的治疗方法。方法 非开胸食管拔脱切除颈段食管癌24例,17例保留喉功能。重建食管用胃上提(19例)或结肠上徙(5例)。术前或术后给予放疗。结果 T2期生存3年者3例,生存5年者1例;T3和T4期生存3年者8例,生存5年者3例。17例保留喉功能,喉功能保留率77.3%(17/22),术后拔管率75.0%(12/16)。并发症发生率为29.2%。结论 颈段食管癌可以行非开胸食管拔脱一期切除肿瘤及周围受侵组织,并尽可能保留喉功能。利用胃上提、结肠上徙重建食管,联合放射治疗,可以提高患者的术后生存率和生存质量。 相似文献
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Hiripi E Jansen L Gondos A Emrich K Holleczek B Katalinic A Luttmann S Nennecke A Brenner H;The Gekid Cancer Survival Working Group 《Acta oncologica (Stockholm, Sweden)》2012,51(7):906-914
Abstract Background. Esophagus and stomach cancers are associated with poor prognosis. But most published population-based cancer survival estimates for stomach and esophagus cancer refer to survival experience of patients diagnosed in the 1990s or earlier years. The aim of this study was to provide up-to-date survival estimates and trends for patients with stomach and esophagus cancer in Germany. Material and methods. Our analysis is based on data from 11 population-based cancer registries, covering 33 million inhabitants. Patients diagnosed with stomach and esophagus cancer in 1997-2006 were included. Period analysis was used to derive five-year relative survival estimates and trends by age, sex, cancer subsite, and stage for the time period of 2002-2006. German and US survival estimates were compared utilizing the SEER 13 database. Results. Overall age-standardized five-year relative survival was 31.8% and 18.3% for stomach and esophagus cancer, respectively, compared to 27.2% and 17.4% in the US. Survival was somewhat higher among female than among male patients for both cancer sites (33.6% vs. 30.6% and 21.5% vs. 17.5%, respectively) and much higher for non-cardia stomach cancer (40.4%) than for cardia cancer (23.4%). From 2002 to 2006, a moderate increase in five-year relative survival by 2.7 percent units was observed for non-cardia stomach cancer patients in Germany (p 0.001). Conclusion. Five-year relative cancer survival has reached levels around 40% for patients with non-cardia stomach cancer in Germany in the early 21st century, whereas it remained at lower levels around 20% for patients with esophagus and cardia cancer. 相似文献
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目的食管和贲门癌切除术后吻合瘘口是常见的并发症之一,为了降低吻合口瘘的发生率,我院心胸外科对食管与胃或肠的吻合方法进行了改进。方法食管与胃空肠结肠吻合采用一层吻合法,共手术2005例,其中食管与全胃吻合1041例,与残胃吻合869例,与空肠吻合85例,与结肠吻合10例。结果全组术后发生吻合口瘘41例(2.0%),死亡15例(36.6%)。结论经临床运用证明一层吻合术具有对合整齐血供好,肿瘤切除率高,吻合口瘘发生率低等优点。改进吻合技术,保护吻合口血供,减少术中污染,降低吻合口张力是预防吻合口瘘的重要措施。 相似文献
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Frequent Loss of TIMP-3 Expression in Progression of Esophageal and Gastric Adenocarcinomas
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Ping Gu Xiangbin Xing Marc Tnzer Christoph Rcken Wilko Weichert Audrius Ivanauskas Matthias Pross Ulrich Peitz Peter Malfertheiner Roland M Schmid Matthias P A Ebert 《Neoplasia (New York, N.Y.)》2008,10(6):563-572
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A new method of anastomosis after resection of esophageal or cardial carcinoma was carried out in 141 patients in our hospital from Feb. 1983 to Sept. 1985. After resection of the tumor, the proximal end of esophagus was invaginated into the stomach lumen and a tight suture was applied between the outer wall of esophagus and stomach. Extroversion suture of the mucosa in the esophageal end, being free in the stomach lumen, was made to prevent bleeding and stenosis. The operative mortality was 0.7% (1/141) and no anastomotic leak was found. Our experiences indicate that this operative procedure is easy, simple and obviously reduces the complication in the anastomotic region. 相似文献
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目的 评价奥沙利铂联合甲酰四氢叶酸、氟脲嘧啶治疗晚期消化道恶性肿瘤的近期疗效和不良反应。方法 对64例消化道恶性肿瘤患者,采用以奥沙利铂为主的方案进行化疗。奥沙利铂130mg/m^2静脉滴注2h,第1天;甲酰四氢叶酸(FA)150mg/m^2静脉滴注2h,第1~5天;5-氟脲嘧啶300mg/m^2静脉滴注4h,第1~5天。3周重复1次,至少化疗2个周期后评价疗效,有效病例4周后评定疗效。结果 共64例患者,食管鳞癌21例中,部分缓解(PR)11例,有效率为52.4%;胃腺癌20例中,PR10例,有效率为50.0%;结直肠癌23例中,完全缓解(CR)1例,PR8例,有效率为39.1%。不良反应主要为感觉神经毒性,骨髓抑制和胃肠道反应。结论 奥沙利铂为主的方案治疗晚期结直肠癌的疗效与国内外报告结果相似,对胃腺癌和食管鳞癌的治疗有较好疗效。不良反应轻,患者能耐受。有必要开展进一步的临床研究。 相似文献