Ⅲ期胸段食管鳞癌根治切除术后预后因素分析  

Prognostic analysis of the patients with stage-Ⅲ esophageal squamous cell carcinoma after radical esophagectomy

作　　者：胡祎[1,2] 郑斌[1,2] 戎铁华[1,2] 傅剑华[1,2] 朱志华[1,2] 杨弘[1,2] 罗孔嘉[1,2] 李永锋[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心胸科,广东广州510060

出　　处：《癌症》2010年第2期190-195,共6页Chinese Journal of Cancer

摘　　要：背景与目的:食管癌治疗首选手术,多数患者就诊时已是局部晚期(以Ⅲ期为主)。本研究回顾性分析手术根治切除的食管鳞癌患者的临床资料,以探讨影响患者术后生存的主要因素。方法:收集1997年1月至2004年3月中山大学肿瘤防治中心行食管癌根治术病例临床资料,其中资料完整361例,应用Kaplan-Meier法进行生存分析,组间比较用log-rank检验,多因素分析采用Cox模型分析。结果:总的1、2、3、4和5年生存率分别为67.7%、40.6%、27.5%、23.4%和20.1%。单因素分析表明肿瘤浸润深度、淋巴结转移度、淋巴结转移区域数、淋巴结转移个数、手术并发症和手术时间均为Ⅲ期胸段食管鳞癌预后影响因素。Cox回归分析显示肿瘤浸润深度、淋巴结转移度和手术并发症是Ⅲ期胸段食管鳞癌预后的独立影响因素。结论:在Ⅲ期胸段食管鳞癌根治术后的临床和病理特征中,淋巴结转移度、肿瘤浸润深度和手术并发症是独立预后因素。Background and Objective： Most patients with esophageal carcinoma have disease in the locally late stage （stage Ⅲ ） when first diagnosed, with surgery as the first treatment of choice. This study analyzed the clinical data of patients with esophageal squamous carcinoma after radical esophagectomy and investigated prognostic factors. Methods. The data of 361 patients with esophageal squamous carcinoma who underwent radical esophagectomy and were hospitalized at Sun Yat-sen University Cancer Center between January 1997 and March 2004 were analyzed. The Kaplan-Meier method was used to analyze prognosis, log-rank test was used to compare the groups, and the Cox proportional hazards model was used for multivariate analysis. Results. The 1-, 2-, 3-, 4-, and 5-year survival rates were 67.7%, 40.6%, 27.5%, 23.4%, and 20.1%, respectively. Based on univariate analysis, the degree of invasion, rate of lymph node metastasis, number of metastatic regions, number of metastatic lymph nodes, postoperative complications, and duration of surgery were prognostic factors. Based on multivariate analysis, the degree of invasion, rate of lymph node metastasis, and postoperative complications were independent factors for the prognosis. Conclusions： Of all clinical and pathologic factors, the degree of invasion, rate of lymph node metastasis, and postoperative complications were independent factors for the prognosis of patients with stage-Ⅲ esophageal squamous carcinoma after radical esophagectomy.

关 键 词：食管肿瘤 手术 预后 

分 类 号：R735.1[医药卫生—肿瘤]