基隆長庚醫院

食道癌治療小組年度報告

2009/10/02

食道癌治療小組成員胸腔外科 : 劉會平胸腔外科 : 陳子平放射腫瘤科 : 蔡介生放射腫瘤科 : 陳彥超放射診斷科 : 陳肇長核子醫學科 : 詹勝傑

病理科 : 黃成正胃腸肝膽科 : 胡瀞之血液腫瘤科 : 王正旭血液腫瘤科 : 葉光揚血液腫瘤科 : 賴建宏

Patient characters

• 117 patients (59 in 2007, 58 in 2008)

• Male: Female 109 : 8 (55+54 : 4+4 )

• SCC: Adeno: other 102 : 8 : 5 (49+53: 4+4: 4+1)

Location of tumor

• Cx 4 (3+1)

• U/3 20 (9+11)

• M/3 68 (36+32)

• L/3 23 (10+13)

• 117 patients• Stage I : 7 (96=4, 97=3)

• Stage II A (T2N0, T3N0) 19 (96=8, 97=11)

• Stage II B (T1n1, T2N1) 8 (96=6, 97=2)

• Stage III (T3N1,T4Nany) 38 (96=25, 97=13)

• Stage IV A 8 (4, 4)

• Stage IV B 27 (9, 18)

Esophageal Cancer

Stage 0 I II III IV *Unk.

Case no. 0 8 28 83 31 30

Total 180From: year 2000 cancer statistics review of CGMH (N. Taiwan)

* Unk. : Unknown

Esophageal Cancer

Histology Case No.

Squamous Cell Carcinoma 177

Adenocarcinoma 8

Carcinoma, Others & NOS 9

Malignant Lymphoma 1

Others 9

Total 204

From: year 2000 cancer statistics review of CGMH (N. Taiwan)

Locally advanced (T3N0, T2N1,T3N1) status 與他院比較

• At NTUH• 97 patients, 2000 ~ 2005• Median age: 56 (range 36 - 77)• Male / Female = 90 / 7• Squamous / Adeno = 92 / 5• Cervical / Upper / Mid / Lower = 8 / 27 /

39 / 23• T3N0 / T2N1 / T3N1 = 8 / 2 / 87

Lin CC, et al. Ann Oncol 2007;18:93-8

Survival ?

• T4 survival• M1a survival• M1b survival• With-2nd primary survival

• 2007 M1b 9/ 59; N1: 43; T4: 12 (PET 22)• 2008 M1b 18/ 58; N1: 32; T4: 18 (PET 36)

• 2007 M1a 4• 2008 M1a 4

• 2007 T1N0M0 4 • 2008 T1N0M0 3

2008 T status on EUS & CT

• T-EUS vs T-CT• EUS 36 attempted, 34 completed• CT > EUS: 8• CT < EUS: 9• CT = EUS: 8

EUS endoscopic ultrasoundCT computed tomography

2nd primary

• 2007 2nd primary 6/ 59• (5 synchronous, 1 HN then eso)• 2008 2nd primary 10/ 58• (6 synchronous, 4 HN then eso)

• So, 2nd primary 2-year 16/ 117 cases 14%

• 2nd primary: • H&N: 11/ 16 (eso all SCC)• HCC: 2/16 (eso all SCC)• CRC: 3/ 16 (eso 2 SCC, 1 adeno)

2008 Tx

• 轉院 7• CCRT: 19 (ITT: 20), ( 3 in LK)• OP: 5• CCRT+OP: 10• OP+CCRT:4• Palliative C/T:4• Suportive care:2• ???: 4: 俞春雄 曹英雄 張家榮 許涼一

2007 Tx

• 轉院 3• CCRT: 26 (ITT: 27), ( 2 in LK)• OP: 3• CCRT+OP: 8 (2 CCRT IN LK)• OP+CCRT: 9 (6 CCRT IN LK) • Palliative C/T: 1• Suportive care: 1• Lost f/u: 1 林春長