食管、贲门癌2837例外科治疗分析

Surgical Treatment for 2837 Cases of Cancers of the Esophagus and Gastric Cardia

目的 探讨提高食管癌的手术切除率及降低手术死亡率和提高远期效果及术后生存质量的措施。方法 对 2 837例外科治疗的食管、贲门癌患者的手术情况及随访结果进行分析。结果 本组手术切除率为98 7% ,手术死亡率为 0 92 %。全组 3年及 5年生存率分别为 4 8 9%和 33 7%。肿瘤的分期 ,肿瘤浸润深度和淋巴结转移影响 5年生存率。术后以颈淋巴结转移较多 ,且多发生在术后 3年内。结论 重视“三早” ,适当扩大切除范围 。

Objective To reseach the way of rising resectable rate,reducing operative mortality,enhancing long-term effect and higher life quality in postoperation for cancers of esophagus and gastric cardia.Method Operation outcome of 2837 cases for cancers of esophagus and gastric cardia and followed-up were analysed.Results Overall resectability was 98.7%,and postoperative mortality was 0 92% in the group.Survival rates of 3 and 5 years were 48.9% and 33.7%,respectively.Factors affecting long-term survival were those of depth of tumor invasion and lymph nodes metastasis and oncologic staging.It was higher for cervical lymph nodes metastasis within 3 years after operation.Conclusions Early discovery and timely treatment,an appropriate enlarging resectable field and comprehensive therapies are the key to improve the long-term survival.