食管癌术后一年内复发的特点及相关因素分析  

Analysis of characteristics and factors affecting the recurrence of esophageal cancer within the first year after surgery

作　　者：谢天鹏[1] 向润[1] 杨晓军[1] 崔岳[1] 李强[1] 

机构地区：[1]四川省肿瘤医院胸外科,成都610041

出　　处：《中华肿瘤杂志》2016年第2期146-149,共4页Chinese Journal of Oncology

摘　　要：目的分析食管癌术后1年内复发的特点及其相关因素。方法收集2010年4月至2013年4月间手术治疗的320例胸段食管癌患者的临床及随访资料，分析1年内复发的特点及相关因素。结果320例患者中，1年内复发72例，1年内复发率为22．5％，复发时间为（6．89±3．53）个月。食管癌术后1年内复发与T分期、N分期、G分级和临床病理分期有关（均P〈0．05）。多因素分析显示，临床病理分期是影响食管癌术后1年内复发的独立因素（P=0．002）。72例复发患者中，局部复发46例（63．9％），其中上纵隔淋巴结转移27例，占局部复发的58．7％（27／46）；远处转移伴或不伴局部复发26例（36．1％），其中肺转移11例，占远处转移的42．3％（11／26）。72例复发患者中，远处转移患者和局部复发患者的淋巴结清扫数目分别为（29．40±11．41）枚和（21．18±10．37）枚，淋巴结转移数目分别为（4．37±5．65）枚和（1．91±2．14）枚，远处转移患者的淋巴结清扫数目和淋巴结转移数目均高于局部复发患者，差异均有统计学意义（均P〈0．05）。结论食管癌术后1年内复发以淋巴结转移为主，临床病理分期是影响食管癌术后1年内复发的独立因素，规范的淋巴结清扫及合理的治疗方式选择是减少术后早期复发的关键。Objective To analyze the characteristics and factors affecting the recurrence in esophageal cancer within the first year after esophagectomy. Methods We reviewed retrospectively the clinical and follow-up data of 320 patients who underwent surgical treatment from April 2009 to April 2013 in Sichuan Provincial Cancer Hospital. Results 72 cases （72/320, 22.5%） had tumor recurrence within the first year after surgery. The average recurrence time was 6.89＋3.53 months and the median recurrence time was 6.02 months. Univariate analysis showed that T stage, N stage, G grade, and pathological stage are related to the recurrence （P〈0.05 for all）. Logistic regression analysis showed that pathological stage is an independent risk factor for recurrence （ P = 0. 002 ）. There were 46 cases （ 46/72, 63.9%） of local recurrence and 26 cases （26/72, 36.1%） of distant metastasis. Among the 46 cases of local recurrence, 27 cases （27/46, 58.7%） had upper mediastinal lymph node metastasis. Among the 26 cases of distant metastasis, there were 11 cases （11/26, 42.3%） of pulmonary metastasis. Among the 72 cases of recurrence, the average number of dissected lymph nodes and involved nodes were 29.40±11.41 and 4.37± 5.65, respectively, in patients with distant metastasis, and 21.18± 10.37 and 1.91±2. lg, respectively, in patients with local recurrence. Both the number of dissected and involved lymph nodes were significantly higher in the patients with distant metastasis （P〈0.05）. Conclusions Lymph node metastasis is the most common pattern of recent relapse after esophagectomy, and pathological stage is an independent risk factor for recurrence within the first year after surgery. Standardized lymph node dissection and rational treatment strategy is the key measures to reduce early recurrence of esophageal cancer.

关 键 词：食管肿瘤 外科手术 肿瘤复发 局部 肿瘤转移 因素分析 统计学 

分 类 号：R735.1[医药卫生—肿瘤]