135例食管鳞癌肺转移预后因素分析

Analysis of prognostic factors in 135 patients with pulmonary metastasis from esophageal squamous cell carcinoma

目的探讨食管鳞癌肺转移患者预后的影响因素。方法回顾性分析2008—2018年间浙江省肿瘤医院135例食管鳞癌治疗后肺转移患者的临床特点。运用Kaplan-Meier法计算生存率,log-rank法单因素预后分析,Cox模型多因素预后分析。结果全组患者中位随访时间为94.2个月(19.5~258.9个月),死亡109例(80.7%)。1、2年生存率分别为47.4%、25.1%,肺转移后中位生存期11.1个月(7.3~14.9个月)。单因素分析显示年龄、肺部转移灶数目、肺转移灶治疗方法、淋巴结转移、伴远处器官转移、首次治疗后至肺转移间隔是影响食管鳞癌肺转移预后的因素(均P<0.05)。多因素分析表明年龄、肺部转移灶数目为食管鳞癌肺转移的独立预后因素(均P<0.05)。结论年龄、肺部转移灶数目是食管鳞癌肺转移的独立预后因素;手术或放疗为主的局部治疗能改善患者预后。

Objective To investigate the prognostic factors of patients with esophageal squamous cell carcinoma with pulmonary metastasis.Methods Clinical characteristics of 135 esophageal squamous cell carcinoma patients presenting with pulmonary metastasis after treatment in Zhejiang Cancer Hospital from 2008 to 2018 were retrospectively analyzed.Thesurvival rate was calculated by Kaplan-Meier method.Univariate analysis was performed by log-rank test.Multivariate prognostic analysis was conducted by Cox models.Results The median follow-up time of 135 patients with esophageal squamous cell carcinoma was 94.2 months(19.5-258.9 months),and 109 patients died(80.7%).The 1- and 2-year overall survival rates were 47.4% and 25.1%,with the median survival time was 11.1 months(7.3-14.9 months).Univariate prognostic analysis showed that age,number of lung metastases,treatment of lung metastases,lymph node metastasis,distant organ metastasis,and the interval between the first treatment and lung metastasis were the prognostic factors of esophageal squamous cell carcinoma with lung metastasis(all P<0.05).Multivariate analysis demonstrated that age and number of lung metastases were the independent prognostic factors for patients with esophageal squamous cell carcinoma with lung metastases(all P<0.05).Conclusions Age and number of lung metastases are the independent prognostic factors for patients with esophageal squamous cell carcinoma with lung metastases.Surgery or radiotherapy-based regional therapy can enhance clinical prognosis.