臨床外科66巻2号

2011年02月発行

特集 T4の癌―臓器別特性と治療戦略

各臓器におけるT4癌の取り扱い

著者： 平田公一¹ 木村康利¹ 沖田憲司¹ 今村将史¹ 信岡隆幸¹ 目黒誠¹ 川本雅樹¹ 原田敬介¹ 西舘敏彦¹ 九冨五郎¹ 水口徹¹

所属機関： ¹札幌医科大学外科腫瘍学・消化器外科治療学

ページ範囲：P.134 - P.139

文献概要

【ポイント】

◆T4癌の治療戦略にあたっては，①切除可能癌，②切除不能癌，および①術前治療奏効癌，②同無効癌に大別して考える必要がある．外科治療にあたっては根治性の点で周囲組織の合併切除を余儀なくされる場合があり，術後のQOLと生命予後成績が天秤にのることとなる．

◆癌診療ガイドラインにおいては，外科治療選択における根治性の可能性と限界，microあるいはmicro metastasisの再発予防効果，などの点でエビデンスに基づいて周術期治療法が紹介されているものがある．

◆癌腫によってはエビデンスが少ないために，次代をめざした臨床研究に依存する解説を示しているものも少なくない．

◆癌腫間での推奨内容を比較すると，エビデンスの質と量には差が大きい．医療情報を正確に把握したうえでインフォームド・コンセント（IC）に尽力する必要があることを意識されたい．

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