影响食管癌患者预后因素的Cox回归分析

Cox regression analysis of prognostic factors in patients with esophageal cancer after oncologic esophagectomy

目的 通过对食管癌患者术后生存状况分析,探讨影响患者预后的相关因素。方法 回顾性分析该科2007-2008年期间104例食管癌切除术患者;调查以问卷形式进行,随访3年。采用Life Tables、Kaplan-Meier、Cox比例风险回归进行生存分析。结果 （1）3年内累积死亡61例,中位生存时间35.23个月,术后第1、2和3年累积生存率分别为87%、62%和48%,以术后第24个月死亡风险最高;（2）单因素分析：饮酒、TNM分期、淋巴结状态是影响预后的因素;（3）多因素分析：淋巴结状态（RR=2.399,P=0.002,95%CI：1.385-4.154）,饮酒（RR=0.470,P=0.008,95%CI：0.269-0.882）,消化道重建方式（RR=1.910,P=0.018,95%CI：1.118-3.262）是影响预后独立因素。结论 食管癌患者预后仍不理想,而淋巴结状态、消化道重建方式和饮酒是影响食管癌预后的危险因素。

Objective To investigate the prognostic factors in analyzing the long-term survival. Methods 104 patients underwent 2007 to 2008 in this hospital,and the investigation was carried on in patients with esophygectomy after oncologic esophagectomy by esophagectomy for cancer were retrospectively reviewed from questionnaire, following up 3 years. Various ways, such as Life Tables,Kaplan-Meier and Cox regression analysis, were used to evaluate long-term survival. Results （1） A total of 61 patients died in 3 years. The median survival time was 35.23 months. The cumulative survival rates at 1,2 and 3 year after surgery were 87 %, 62 %, and 48 % respectively, and death hazard in 24th month after surgery was the highest. （2）In univariate analysis：drinking, presence of lymph node metastasis and TNM staging were significant factors that influenced long-term survival. （3）Multivariate analysis：lymph node（RR=2. 399,P=0. 002,95%CI：1. 385 to 4. 154）,drinking（RR=0. 470,P=0. 008,95;CI：0. 269 to 0. 882） ,digestive tract construetion（RR= 1. 910, P = 0. 018,95 % CI： 1.118 to 3. 262） were the isolated factor influencing the prognosis. Conclusion Patients after oneologic esophagectomy generally suffer poor survival. The presence of lymph node metastasis, drinking and different methods of reconstraction are statistically significant factors influencing long-term survival.