pT4期食管癌患者术后疗效分析

Survival of Stage pT4 Esophageal Carcinoma Patients After Surgery

目的回顾性分析p T4期食管癌患者术后的疗效及其影响因素。方法收集77例pT4N0~3M0期食管癌患者术后资料;采用Cox单因素和多因素法分析其术后疗效和影响因素。结果至随访期结束,全组术后3、5年生存率和中位生存期(OS)分别为39.0%、35.3%和24月;单因素分析,病变部位和pN分期与OS有关(P<0.05),Cox多因素分析发现仅pN分期是影响OS的独立危险因素。全组术后3、5年无进展生存率和中位无进展生存期(PFS)分别为43.6%、34.6%和21月;单因素分析发现病变部位和pN分期与PFS有关(P<0.05);Cox多因素分析发现pN分期和清扫淋巴结数目是影响PFS的独立危险因素。结论 pT4期食管癌术后疗效不佳,pN分期是预后独立危险因素,分期越晚、预后越差;病变部位也影响疗效。

Objective To retrospectively analyze the survival and its related factors of the patients with stage pT4 esophageal carcinoma （EC） after resection. Methods From Jan, 2008 to Dec, 20ll, 77 patients with stage pT4N0-3M0 EC after resection were enrolled. Cox univariate and multivariate analysis were used to evaluate the postoperative survival and its related factors. Results Until the end of follow-up, the 3-, 5-year survival rates and median overall survival （OS） were 39.0%, 35.3% and 24 months, respectively. Univariate analysis showed that tumor lesion and stage pN were associated with OS （P〈0.05）; multivariate analysis revealed that stage pN was the only independent factor for OS. The 3-, 5-year progression-free survival （PFS） rates and median PFS were 43.6%, 34.6% and 21 months; univariate analysis showed that tumor lesion and stage pN were associated with PFS（P〈0.05）; multivariate analysis revealed stage pN and removal lymph node number were the independent factors for PFS. Conclusion The survival of stage pT4N0-3M0 EC patients after surgery is poor. Stage pN is the most important independent factor for OS and PFS. Tumor lesion is also related with OS and PFS.