pT2~3N0M0胸段食管鳞癌患者术后生存及影响因素分析  

A retrospective analysis of survival and prognostic factors for thoracic esophageal squamous cell carcinoma with stage pT2-3N0M0 after radical surgery

作　　者：朱礼阳 陈东波[1] 夏万里[1,2] 康宁宁[1,2] 康梅[1] 张丽[1] 汪义纯[1] ZHU Liyang;CHEN Dongbo;XIA Wanli;KANG Ningning;KANG Mei;ZHANG Li;WANG Yichun(Department of Radiation Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China)

机构地区：[1]安徽医科大学第一附属医院肿瘤放疗科,合肥230022 [2]安徽医科大学第一附属医院普胸外科,230022

出　　处：《临床肿瘤学杂志》2020年第11期993-998,共6页Chinese Clinical Oncology

摘　　要：目的探讨pT2~3N0M0胸段食管鳞癌患者术后的生存状况及影响因素。方法回顾性分析2011年6月至2017年6月行单纯根治性手术的175例pT2~3N0M0患者的临床资料。分析不同纳入因素(性别、年龄、病变部位、病变长度、病变宽度、病理T分期、分化程度、神经侵犯状态、脉管癌栓及淋巴结清扫数目)对总生存时间(OS)和无病生存时间(DFS)的影响。生存分析采用Kaplan-Meier法,预后多因素分析采用Cox比例风险回归模型。结果全组患者的1、3、5年生存率为88.6%、58.3%、47.3%,中位OS为49.0个月;1、3、5年无病生存率为74.8%、36.6%、23.9%,中位DFS为24.0个月。Cox多因素分析显示,病理T分期(HR=1.620,95%CI:1.075~2.441)和神经侵犯状态(HR=5.778,95%CI:2.718~12.283)是影响OS的独立因素(P<0.05);病理T分期(HR=1.547,95%CI:1.080~2.216)、神经侵犯状态(HR=2.930,95%CI:1.403~6.117)和病变部位(中段vs.上段:HR=0.561,95%CI:0.334~0.944;下段vs.上段:HR=0.436,95%CI:0.221~0.859)是影响DFS的独立因素(P<0.05)。结论病理T分期和神经侵犯状态是影响pT2~3N0M0胸段食管鳞癌患者术后OS及DFS的独立因素,病变部位亦是影响DFS的独立因素。Objective To investigate the survival and prognostic factors for thoracic esophageal squamous cell carcinoma(TESCC)with stage pT2-3N0M0 after radical surgery.Methods From June 2011 to June 2017,175 TESCC patients with pathological T2-3N0M0 underwent radical surgery without perioperative therapies were enrolled in this study.The influencing factors,including sex,age,location of tumor,length of tumor,width of tumor,pathological T stage,differentiation,perineural invasion,vessel invasion and number of resected lymph nodes on overall survival(OS)and disease-free survival(DFS)was analyzed.The Kaplan-Meier method was used for survival analysis.Multivariate factors analysis was performed by Cox proportional hazard regression model.Results The median OS was 49.0 months,and the1-,3-,5-year survival rates were 88.6%,58.3%and 47.3%,respectively.The median DFS was 24.0 months,and the 1-,3-,5-year disease-free survival rates were 74.8%,36.6%and 23.9%,respectively.The Cox regression analysis indicated that the T stage(HR=1.620,95%CI:1.075-2.441)and perineural invasion(HR=5.778,95%CI:2.718-12.283)were independent factors influencing OS,and T stage(HR=1.547,95%CI:1.080-2.216),perineural invasion(HR=2.930,95%CI:1.403-6.117)and location of tumor(middle vs.upper TESCC:HR=0.561,95%CI:0.334-0.944;lower vs.upper TESCC:HR=0.436,95%CI:0.221-0.859)were independent factors influencing DFS.Conclusion Pathological T stage and perineural invasion are independent factors for OS and DFS.The location of tumor is also an independent factor for DFS.

关 键 词：食管鳞癌 根治术 预后 pT2-3N0M0 

分 类 号：R735.1[医药卫生—肿瘤]