老年食管癌及贲门癌患者外科治疗分析

Surgical Treatment of Elderly Patients with Carcinoma of the Esophagus or Cardia Associated with Pulmonary and Cardiac Diseases: A Report of 62 Cases

作者对62例老年食管癌和贲门癌并肺、心疾病患者进行了手术探查和肿瘤切除,并与62例青壮年食管癌和贲门癌患者进行了对照。两组病例术后30d内均无死亡,咽下困难获得满意解除。1～5年生存率老年组明显优于对照组(P<0.001)。年龄、临床分期、癌切除彻底性和癌复发或转移影响预后。并对这些病例接受外科切除的可能性和肺粘连反应的存在对预后可能有益等进行了讨论。

62 elderly patients with carcinoma of the esophagus or cardia associated with pulmonary and cardiac diseases underwent surgical exploration and resection of tumors, and the results were compared with those of 62 young and middle aged patients with carcinoma of the esophagus or cardia. None of them died 30 days after operation. Satisfactory relief of dysphagia was achieved in all patients. The overall 5-year survival rate was higher in the treatment group (81%) than in the control one (24 %). The difference was statistically significant (P<0.05). Prognosis was related directly to age, clinical staging, complete tumor resection, and tumor recurrence or metastasis, etc. In addition, the acceptability of surgical resection in these cases and a more favorable prognosis with the presence of pulmonary adhesive reaction were also discussed.