pN0胸段食管鳞癌术后复发转移的危险因素探讨

Study of risk factors for postoperative recurrence and metastasis of thoracic esophageal squamous carcinoma at pN0 stage

目的探讨p N0胸段食管鳞癌术后复发、转移的高危因素,为术后采取合理辅助治疗提供临床依据,提高患者远期生存率。方法回顾性分析福建省泉州市光前医院肿瘤外科2003-01～2010-12收治的76例p N0胸段食管鳞癌患者的临床资料,应用Cox比例风险回归模型分析术后3年内肿瘤复发、转移的危险因素。结果术后3年内复发转移率为34.2%。单因素分析结果显示,肿瘤部位、p T分期、有无脉管癌栓与术后复发、转移相关（P〈0.05）。多因素分析结果显示,食管中上段癌、p T3-4a、脉管癌栓是影响p N0胸段食管鳞癌术后复发、转移的独立风险因素。结论胸中上段癌、p T3-4a、脉管癌栓是p N0胸段食管鳞癌术后复发、转移的独立风险因素,术后应给予积极辅助治疗。

Objective To explore the high-risk factors for postoperative recurrence and metastasis of thoracic esophageal squamous carcinoma during p N0 stage,and to provide rational postoperative adjuvant treatment and enhance long-term survival rate. Methods Clinical data of 76 patients diagnosed with thoracic esophageal squamous carcinoma（ p N0 stage）,admitted to Quanzhou Guangqian Hospital,Fujian Province from January 2003 to December2010 were analyzed retrospectively. Cox proportional-hazards regression model was adopted to analyze the risk factors for recurrence and metastasis within postoperative 3 years. Results The recurrent metastasis rate was 34. 2% within postoperative 3 years. Univariate analysis revealed the tumor location,p T staging and vascular thrombosis were correlated with postoperative recurrence and metastasis（ all P〈0. 05）. Multivariate analysis suggested that the middle and upper esophageal cancer,p T3-4a and vascular thrombosis were the independent risk factors for the postoperative recurrence and metastasis of thoracic esophageal squamous carcinoma during p N0 stage. Conclusion The middle and upper esophageal cancer,p T3-4a and vascular thrombosis act as independent risk factors for the postoperative recurrence and metastasis of thoracic esophageal squamous carcinoma during p N0 stage. Postoperative adjuvant treatment should be delivered actively.