异时性食管癌和胃癌的临床特征及预后分析

Clinical characteristics and prognostic factors in metachronous primary esophageal and gastric carcinomas

目的探讨异时性食管癌和胃癌的临床特征及影响预后的因素。方法收集1979年7月至2005年3月诊治的27例异时性食管鳞癌和胃腺癌患者的临床资料，并进行预后单因素分析。结果全组患者有肿瘤家族史者占29．6％。总5年生存率为61．0％，10年生存率为52．0％，中位生存期为105个月。单因素预后分析显示，手术切除是影响异时性食管癌和胃癌患者预后的重要因素。结论异时性食管癌和胃癌患者有独特的临床特点，部分患者有遗传背景，治疗效果较好；手术切除是异时性食管癌和胃癌主要和有效的治疗方式。

Objective To investigate the clinical characteristics and prognostic factors in metachronous squamous cell carcinoma of the esophagus and gastric adenocarcinoma. Methods From July 1979 to March 2005, 27 patients with metachronous carcinomas of the esophagus and stomach were treated, and the data were retrospectively reviewed. The clinical features were analyzed, which included sex, age, family history of cancers, TNM stages of the gastric and esophageal carcinomas, resection mode, chemotherapy and/or radiotherapy, and the sequence of the two carcinomas taking place. Results There were 27 patients in this series including 24 males and 3 females, with a median age of 60 years（range： 36 73 years）. Of the 27 patients, 29.6% had a family history of malignant tumors. The overall 5- and 10-year survival rates were 61.0% and 52. 0%, respectively, with a median survival of 105 months. Patients treated with surgical resection had a significantly longer survival than those without （P 〈0.001 ）. Conclusion Metachronous squamous cell carcinoma of the esophagus and gastric adenocarcinoma show distinct clinical characteristics. Surgical resection is mostly effective and the first choice of treatment.