92例Siewert Ⅱ型和Ⅲ型贲门癌的预后因素分析

Analysis of prognostic factors in 92 patients with Siewert Ⅱ and Ⅲ type of cardia cancer

目的探讨影响SiewertⅡ、Ⅲ型贲门癌患者预后的影响因素。方法收集2000年4月至2012年4月接受手术治疗的92例贲门癌患者的临床资料并随访患者生存情况,影响5年生存率及总生存期(OS)的因素。结果截止2012年9月1日,92例患者共死亡53例,5年生存率为27.4%,中位OS为36.0个月。Siewert分型、T分期、N分期和UICC分期是贲门癌5年生存率的影响因素,但与年龄、病理类型、Lauren分型、手术方式及淋巴结清扫方式均无关(P>0.05)。Cox多因素分析显示,T分期、N分期是影响SiewertⅡ、Ⅲ型贲门癌预后的独立因素。结论 T分期、N分期是影响贲门癌预后的独立因素;Siewert分型因素的影响作用尚具有不确定性,但对贲门癌手术方式的选择具有指导意义。

Objective To explore the prognostic factors in 92 patients with SiewertⅡandⅢtype of cardia cancer. Methods Ninety-two patients with Siewert Ⅱ and Ⅲ type of cardia cancer admitted by our hospital from April 2000 to April 2012 were en-rolled. The clinical data were collected and the patients were followed up for the 5-year survival rate and median overall survival（ OS） . The univariate analysis and Cox regression hazard model analysis were used to analyze the factors affecting the prognosis for SiewertⅡandⅢtype of cardia cancer. Results At the end of the follow-up period（ September 1, 2012） , 53 out of 92 patients died with the 5-year survival rate of 27.4% and the median OS of 36.0 months. There were significant differences on 5-year survival rates between dif-ferent Siewert type, T stage, N stage and UICC staging（P〈0.05）. The 5-year survival rates were unrelated to age, histopathology, Lauren type, lymph node dissection and surgical approach. T stage and N stage were independent factors affecting the prognosis for Siewert Ⅱ,Ⅲtype of cardia cancer. Conclusion T stage and N stage were the independent factors affecting the cardia cancer of gas-troesophageal junction. Siewert type can provide useful information for determining the appropriate surgery.