手术治疗高龄食管癌患者预后相关因素分析  

Outcome after esophagectomy for esophagus cancer patients aged over 70 years

作　　者：陶开义[1] 江洪[1] 毛伟敏[1] 周鑫明[1] 陈奇勋[1] 蒋友华[1] 刘金石[1] 赵强[1] 

机构地区：[1]浙江省肿瘤医院胸部肿瘤外科,浙江杭州310022

出　　处：《中华肿瘤防治杂志》2011年第21期1703-1707,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨高龄食管癌患者外科手术治疗的临床及其预后影响因素。方法:回顾性分析行根治性食管癌切除术的161例>70岁食管癌患者的临床资料,分析高龄食管癌患者的手术特点、围手术期死亡及预后危险因素。结果:总体1、3和5年生存率分别为77.0%、49.8%和35.9%,平均生存时间为(49.148±4.088)个月,中位生存时间为(34±6.473)个月。单因素分析结果显示,肿瘤分化程度、肿瘤浸润深度、淋巴结转移与否、淋巴结转移度(淋巴结转移数占总清除淋巴结数比例)、病理分期、肺功能和淋巴结转移区域数是术后生存时间的影响因素,P<0.05。多因素分析结果显示,肿瘤浸润深度和淋巴结转移度是患者预后的重要独立危险因素,P<0.05。其中淋巴结转移度是最重要的预后影响因素,OR=4.067,P<0.001。术后并发症发生率为24.2%(39/161),围手术期死亡率为3.1%(5/161)。结论:选择性老年食管癌患者的手术治疗可获得理想的长期生存,肿瘤浸润深度和淋巴结转移度是患者预后的重要独立危险因素。OBJECTIVE： To retrospective analyze the outcome after esophagectomy for cancer of the esophagus in patients aged over 70 years. METHODS： The clinicopathologic data of 161 patients aged over 70 years with esophageal carcinoma, underwent esophagectomy were analyzed. RESULTS： The overall 1-, 3 , and 5-year survival rates were 77. 0%, 49.8% and 35.9%, mean survival time （49. 148 ± 4. 088） months, median survival time （34 ±6. 473）months. Univariate analysis revealed that the factors affect- ing the prognosis including lung functions, depth of invasion, de gree of tumor differentiation, lymph node metastasis, lymph nodes metastasis ratio, regions of lymph node metastases and pathologic stages （P^0.05）. Multivariate analysis showed that depth of in vasion, lymph node metastasis ratio were independent prognostic factors （P〈0.05）. The lymph node metastasis ratio was the most impartant effect factors （OR= 4. 067, P〈0. 001）. The postoperation complications rate was 24.2 % （36/161）, and the perioperative period death rate was 3.1 G （ 5 / 161 ）. CONCLUSIONS ： Preopera tive assessment should be applied in the selection of the candidates for surgery. Depth of invasion, lymph node metastasis ratio are in dependent prognostic factors of esophageal carcinoma. Standardized esophagectomy is still the primary treatment for esophageal cancer.

关 键 词：食管肿瘤/外科学 预后 老年人 

分 类 号：R735.1[医药卫生—肿瘤]