内容紹介
A Case of Far Advanced-Esophageal Squamous Cell Carcinoma Successfully Treated with Docetaxel
Summary
A 65-year-old man with dysphagia and hoarseness was admitted to our hospital. The upper gastrointestinal examinations revealed a tumor in the lower esophagus while the biopsy specimens revealed squamous cell carcinoma. The clinical diagnosis was esophageal cancer(Lt, type 2, cT3N4M0, cStageⅣa). The patient underwent neoadjuvant-chemotherapy(5-fluorouracil/cisplatin). After one course, computed tomography(CT)showed rapid growth of the tumor and lymph nodes, resulting in a progressive disease. It was considered unresectable because of the direct invasion of the No. 1 lymph node to the liver. Then, three courses of docetaxel were administered as second-line chemotherapy, and CT revealed the markedly reduced size of the tumor and lymph nodes, resulting in a partial response. The tumor was now thought to be resectable. Subtotal esophagectomy could be performed and the postoperative course was uneventful. Histopathological findings showed no evidence of malignancy at the primary tumor(grade 3), although there were residual atypical keratinocytes in some lymph nodes. The patient is doing well without any signs of recurrence 21 months after the surgery.
要旨
症例は65歳,男性。主訴はつかえ感および嗄声。精査の結果,食道癌(Lt,cT3N4M0,cStageⅣa)の診断にて術前補助化学療法の方針となった。5-fluorouracil/cisplatinを1コース施行後,効果判定にて原発巣および転移リンパ節も増大,No. 1リンパ節が肝に浸潤したため切除不能となった。second-lineとしてdocetaxel療法を3コース施行したところ,部分奏効,No. 1リンパ節の肝浸潤も解除されたため,手術可能となった。手術は,右開胸開腹胸部食道亜全摘+後縦隔経路胃管再建+両側頸部リンパ節郭清術を施行した。術後経過良好にて術後13病日で退院となった。病理組織学的所見では原発巣がgrade 3,リンパ節に癌遺残が認められ,部分奏効の評価であった。術後21か月経過し無再発生存中である。
目次
Summary
A 65-year-old man with dysphagia and hoarseness was admitted to our hospital. The upper gastrointestinal examinations revealed a tumor in the lower esophagus while the biopsy specimens revealed squamous cell carcinoma. The clinical diagnosis was esophageal cancer(Lt, type 2, cT3N4M0, cStageⅣa). The patient underwent neoadjuvant-chemotherapy(5-fluorouracil/cisplatin). After one course, computed tomography(CT)showed rapid growth of the tumor and lymph nodes, resulting in a progressive disease. It was considered unresectable because of the direct invasion of the No. 1 lymph node to the liver. Then, three courses of docetaxel were administered as second-line chemotherapy, and CT revealed the markedly reduced size of the tumor and lymph nodes, resulting in a partial response. The tumor was now thought to be resectable. Subtotal esophagectomy could be performed and the postoperative course was uneventful. Histopathological findings showed no evidence of malignancy at the primary tumor(grade 3), although there were residual atypical keratinocytes in some lymph nodes. The patient is doing well without any signs of recurrence 21 months after the surgery.
要旨
症例は65歳,男性。主訴はつかえ感および嗄声。精査の結果,食道癌(Lt,cT3N4M0,cStageⅣa)の診断にて術前補助化学療法の方針となった。5-fluorouracil/cisplatinを1コース施行後,効果判定にて原発巣および転移リンパ節も増大,No. 1リンパ節が肝に浸潤したため切除不能となった。second-lineとしてdocetaxel療法を3コース施行したところ,部分奏効,No. 1リンパ節の肝浸潤も解除されたため,手術可能となった。手術は,右開胸開腹胸部食道亜全摘+後縦隔経路胃管再建+両側頸部リンパ節郭清術を施行した。術後経過良好にて術後13病日で退院となった。病理組織学的所見では原発巣がgrade 3,リンパ節に癌遺残が認められ,部分奏効の評価であった。術後21か月経過し無再発生存中である。