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要旨 2000年2月から2009年8月までに治療を行った中・下咽頭表在癌 168例265病変を対象とし,長期予後とリンパ節転移,遠隔転移のリスクを評価した.治療は内視鏡治療を224病変(ELPS 139,EMRC 85)に施行した.中・下咽頭表在癌のリンパ節転移,遠隔転移と考えられた症例は6例であった.肉眼型はType 0-I 4例,Type 0-IIa 1例,Type 0-III 1例,深逹度は全例SEP,5例が脈管侵襲陽性であった.現病死4例,他病死28例,overall で3年生存率80.2%,cause specificで3年生存率96.6%であった.中・下咽頭表在癌の現病予後は良好で,その予後はむしろ併存疾患や重複癌で規定されていた.リンパ節転移や遠隔転移のリスクファクターは肉眼型がType 0-IやType 0-III,脈管侵襲陽性の症例であった.
Recent advances in endoscopic procedures, such as magnifing endoscopy and the NBI(narrow band imaging)system have enabled precise observation of the oropharynx and the hypopharynx. We developed ELPS(endoscopic laryngo-pharyngeal surgery)as endoscopic treatment for superficial carcinoma of the larynx and the pharynx. One hundred and sixty-eight patients who had superficial carcinoma of the oropharynx and the hypopharynx were treated in Kawasaki Municipal Hospital from January 2000 to August 2009. Cervical lymph-node metastasis occurred in 5 patients and lung metastasis occurred in 1 patient. 4 patients died of hypopharyngeal carcinoma, and 28 patients died of other diseases. The overall survival rate at 3 years was 80.2%, and cause-specific survival rate at 3 years was 96.6%. The important factors for predicting lymph node metastasis and distant metastasis are Type 0-I or Type 0-III and angiolymphatic invasion.
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