Changes of Immunological Parameters after Esophageal Cancer Operation According to Post-operative Adjuvant Therapy

Yorikazu Niitsu, Kaoru Ishida, Keiko Kimura, Kazumi Okamoto, Koji Murakami, Masanori Terashima, Nobuhiro Sato, Kennichirou Ikeda, Chihaya Maesawa, Hiroko Nemoto, Keisuke Koeda, Kazuyoshi Saito

First Department of Surgery, School of Medicine, Iwate Medical University

We operated on 151 patients with thoracic esophageal cancer from August 1984 to December 1989, and examined them for post-operative immunological changes under careful nutritional support according to three groups of post-operative adjuvant therapy. One group of patients received radiation on the cervical and upper mediastinal field at 50 Gy, the second group was treated by CDDP 50-75 mg/m² and VDS 3 mg/m² two times each, and the third group received only surgery consisting of lymphadenectomy in three fields. Nutritional support was given mainly by the enteral route and 40 Kcal/kg or more of energy was administered. In the surgery alone group, immunological parameters recovered to the pre-operative values 4-6 weeks after the operation. In the chemotherapy group, similar changes were observed. On the other hand, suppression of immunological parameters, especially total lymphocyte count, T-cell count, B-cell count, helper and cytotoxic T-cell count, and NK-cell count, was observed. But there was no sever sepsis, and performance rates, from the first day and throughout the time adjuvant therapy was given, were satisfactory. Therefore, we emphasize the effectiveness of nutritional support.

Key words
esophageal cancer surgery, post-operative adjuvant therapy, helper T-cell, NK cell, enteral nutrition

Reprint requests
Yorikazu Niitsu First Department of Surgery, School of Medicine, Iwate Medical University
19-1 Uchimaru, Morioka, 020 JAPAN

Accepted
April 1, 1992

To read the PDF file you will need Abobe Reader installed on your computer.