53例局限期原发食管小细胞癌治疗与预后分析

Treatment and Prognosis of 53 Cases with Localised Primary Esophageal Small Cell Carcinoma

[目的]分析局限期原发食管小细胞癌的治疗疗效及预后。[方法]回顾性分析2002年1月至2011年12月经病理证实的53例局限期原发食管小细胞癌患者的临床资料。生存率分析采用Kaplan-Meier方法,组间生存率比较用Log-Rank检验,预后因素采用Cox回归分析。[结果]全组中位随访时间18个月,中位生存时间14.5个月。1、3、5年生存率分别为62.3%、29.2%、15.6%。手术联合放化疗组的中位生存时间为17.4个月,单纯手术组的中位生存时间为7.1个月,两者比较有统计学差异(P=0.007)。单因素生存分析显示,基础疾病、治疗原则、区域淋巴结转移、脉管瘤栓等因素对预后有影响;Cox回归分析显示脉管瘤栓是影响预后的独立因素。[结论]脉管瘤栓是局限期原发食管小细胞癌的独立预后因素,综合治疗可改善患者生存。

[Purpose] To investigate the treatment efficacy and prognosis of localised primary esophageal small cell carcinoma（PESC）.[Methods] Clinical data of 53 patients with localised PESC from Jan.2002 to Dec.2011 were reviewed.The survival rate was analyzed by Kaplan-Meier method and Log-Rank test.Prognostic factors were analyzed by Cox regression.[Results] The median survival of 53 patients was 14.5 months,and 1-,3-,5-year survival rates were 62.3%,29.2% and 15.6% respectively.Median survival of surgery combined with radiochemotherapy group was 17.4 months,that of surgery alone group was 7.1 months,with significant difference（P=0.007）.Univariate prognostic analysis showed complicated with other diseases,treatment matality,regional lymph node metastasis,vessel involvement were prognostic factors.Multivariate analysis by Cox regression showed that vessel involvement was the only independent prognostic factor for PESC.[Conclusion] Vessel involvement is the independent prognostic factor for localised PESC,comprehensive therapy may improve the survival of PESC patients.