[Preoperative diagnosis of residual tumor in esophageal cancer following radiation therapy].

Grudnaia khirurgiia (Moscow, Russia) Pub Date : 1989-09-01
A I Pirogov, S N Nered
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Abstract

The authors analyse 100 operations for resection of the esophagus after radiotherapy. Morphological examination before irradiation showed squamous cell carcinoma in all patients. Difficulties arise in the diagnosis of a residual esophageal tumor after radiotherapy, as a result of which 11 (14.5%) of 76 patients irradiated with a dose of 30-40 GY and 1 (4.2%) of 24 patients who received a dose of 50-70 Gy were exposed to the risk of a surgical intervention in the absence of morphological signs of a tumor in the removed esophagus. The difficulties of the diagnosis are due to resorption of the tumor under the effect of radiotherapy, its exophytic component in particular, the frequent submucosal position of the tumor, signs of therapeutic pathomorphosis of the tumor, and fibrosis of the esophageal wall.

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食管癌放疗后残留肿瘤的术前诊断。
作者对100例放疗后食管切除术进行了分析。照射前形态学检查均显示为鳞状细胞癌。放疗后残留食道肿瘤的诊断出现困难,因此,76名接受30-40 GY剂量放疗的患者中有11名(14.5%),24名接受50-70 GY剂量放疗的患者中有1名(4.2%)在切除的食道中没有肿瘤形态学征象的情况下面临手术干预的风险。诊断的困难是由于肿瘤在放疗作用下的吸收,特别是其外生性成分,肿瘤的粘膜下位置频繁,肿瘤的治疗性病理病变的迹象,以及食管壁的纤维化。
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