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外科治疗高龄食管癌患者预后的多因素分析

Prognostic factors for survival after esophageal cancer surgery in elderly patients
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摘要 目的探讨70岁以上老年食管癌患者术后生存情况及其影响因素,为制订高龄食管癌患者的治疗方案提供依据。方法回顾性分析102例行手术治疗的70岁以上老年食管癌患者术后生存情况,采用Kaplan-Meier曲线及Log-rank检验生存率差异,分析各种因素对生存率的影响。结果全组3年及5年生存率分别为19.5%、11.7%,术前放化疗、病理分期、术后化疗、肿瘤位置、术前合并症均可显著影响患者的预后,其中前三者为独立预后因素。结论老年食管癌患者应当注重术前、术后的综合治疗,控制术前的合并症以及进行适合的术前放化疗可以显著提高患者的生存率。 Objective With the prolongation of average life span, there are increasing numbers of elderly surgical patients with esophageal cancer. The purpose of this study was to examine the prognostic factors of surgical resection in patients over 70 years of age. Methods Data were retrospectively analyzed from 102 patients aged 〉 70 years who underwent esophageal cancer surgery. The significance of prognostic factors was assessed by univariate and multivariate COX regression analysis. Results The total 5-year survival rate was 11.7% in this series. Age, sex,histology had no impact on survival. Muhivariable COX analysis demonstrated that chemo- radiation therapy ( P = 0.003 ) , pathologic stage ( P 〈 0. 001 ) and chemotherapy after operation( P = 0. 002 ) , were significant, independent, unfavorable prognostic determinants in the patients. Conclusions We should pay more attention to preoperative and post-operative combined therapy of elder esophageal carcinoma patients, control of preoperative complications and suitable preoperative themoradiotherapy thereby raising the survival rate significantly.
出处 《武警医学》 CAS 2009年第4期333-336,共4页 Medical Journal of the Chinese People's Armed Police Force
关键词 食管肿瘤 外科手术 老年病学 多因素分析 Esophageal cancer Surgery Elderly patients Prognosis
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