上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (7): 1020-.doi: 10.3969/j.issn.1674-8115.2017.07.024

• 论著（临床研究） • 上一篇    下一篇

高龄食管癌患者手术治疗的预后分析#br#

王聿明，钱晓哲，曹子昂，赵晓菁，叶清   

  1. 上海交通大学 医学院附属仁济医院胸外科，上海 200127
  • 出版日期:2017-07-28 发布日期:2017-08-25
  • 通讯作者: 叶清，电子信箱：yeqing1@ Hotmail.com
  • 作者简介:王聿明（1990—），男，硕士生；电子信箱：15000057327@163.com

Analysis of prognosis of aged esophageal cancer patients after esophagectomy

WANG Yu-ming, QIAN Xiao-zhe, CAO Zi-ang, ZHAO Xiao-jing, YE Qing   

  1. Department of Cardiothoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2017-07-28 Published:2017-08-25

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摘要： 目的 · 探讨高龄食管癌患者手术治疗预后的影响因素。方法 · 收集 103 例高龄（≥ 80 岁）食管癌且接受手术治疗患者的临床 资料。分析患者性别、年龄、临床表现、术前伴随疾病、术后并发症、肿瘤 T 分期、淋巴结转移情况、肿瘤最长径、肿瘤发生部位及 手术方式等因素对患者术后生存期的影响。结果 · 103 例患者的术后 1、3、5 年生存率分别为 63.2%、15.9%、2.7%。Kaplan–Meier 法 生存曲线分析显示：肿瘤 pT 分期为 T1、T2 期患者的术后生存期明显优于 T3 期患者，其中 pT1 分期患者 3、5 年生存率分别为 50%、 25%。Cox 回归多因素分析结果显示，影响术后生存的独立因素为肿瘤pT 分期、肿瘤最长径、术后并发症和淋巴结转移情况。结 论 · 对于 80 岁以上的高龄食管癌患者，肿瘤最长径小、术后并发症少且无淋巴结转移患者的术后生存期较长，选择T 分期相对更早 （T1、T2）的患者实施手术治疗可以获得较为理想的术后生存期。

关键词: 高龄食管癌, 食管手术, 预后

Abstract:

Objective · To investigate factors affecting the prognosis of aged esophageal cancer patients after esophagectomy.  Methods · Clinical data of 103 aged patients ( ≥ 80 years old) undergoing esophagectomy were collected. Effects of age, sex, clinical manifestations, pre-operative diseases, postoperative complications, T stage, lymph node metastasis, maximum diameter and location of the tumor, and surgical methods on the post-operative survival were analyzed.  Results · 1, 3, and 5 years survival rates of 103 patients were 63.2%, 15.9%, and 2.7%, respectively. Kaplan–Meier survival curve analysis indicated that the post-operative survival was significantly higher in patients with T1 and T2 stages than in patients with T3 stage. The 3 and 5 y survival rates of patients with T1 stage were 50% and 25%, respectively. Results of Cox regression multivariate analysis showed that T stage, maximum diameter of tumor, postoperative complications, and lymph node metastasis were independent factors affecting the post-operative survival.  Conclusion · Esophageal cancer patients aged over 80 years with smaller tumor diameters, less postoperative complications, and negative lymph node metastasis have a longer postoperative survival period. Esophagectomy for patients with earlier stages (T1 and T2) can achieve an ideal post-operative survival period.

Key words: esophageal cancer, esophageal surgery, prognosis