影响食管癌切除术后患者预后的多因素分析

Multivariate Analysis on Prognostic Factors After Curative Esophagectomy for Esophageal Carcinoma

目的 探讨影响食管癌切除术后患者预后的因素。方法 从 5 2 5例食管癌患者的临床病理和随访资料中选择 12项指标 ,先后进行单因素和逐步Cox回归分析 ,建立术后生存预测模型。结果 淋巴结转移数目、TNM分期、肿瘤浸润深度、肿瘤长度和生长部位是影响患者预后的主要因素 (P <0 .0 1) ;预后指数值小的患者预后好。结论 淋巴结转移是影响食管癌切除术后患者预后的最主要因素 ,为提高患者预后 ,应加强对区域淋巴结的处理 ;可应用预测模型来预测不同患者的术后生存率。

Objective To determine the prognostic factors for esophageal carcinoma patients with curative esophagectomy.Methods From 1985 to 1995,there were 525 patients with esophageal carcinoma undergone esophagectomy.Twelve possible factors influencing survival of these patients were collected.A multivariate analysis of these variables was performed by Cox proportional hatard model.According to the prognostic index(PI) all patients were divided into three risk groups,and their predicting models of survival rates after resection were established for each group.Results The statistical results showed that the major significant prognostic factors influencing survival were the numbers of lymph node metastases,TNM staging,depth of invasions,location and length of the tumors(P<0.01).Patients with smaller value of PI had a better prognosis.Conclusion Lymph node metastases were the most important prognostic factor for esophageal carcinoma after resection.Esophagectomy with lymphadenectomy should be done to improve survival rate.The survival probability may be predicted according to the predicting model of survival rates.