淋巴结转移状况对食管癌预后的影响

The Influence on Patients' Prognosis of the Esophageal Carcinoma Made by the Lymph Node Metastasis

目的 探讨淋巴结转移状况对食管癌预后的影响。方法 对 2 13例食管癌病人的临床资料进行回顾性分析 ,单纯手术 14 8例 ,综合治疗 65例 ,左开胸食管胃胸内吻合 192例 ,左胸左颈两切口食管胃颈部吻合 11例 ,左颈、右胸腹正中三切口食管胃颈部吻合 10例 ,术中均清扫手术野范围内淋巴结 ,分析淋巴结转移状况及不同治疗方案对五年生存率的影响。结果 无淋巴结转移及有淋巴结转移者 5年生存率分别为 5 6 4%、16 1% ,具有显著性差异 ,淋巴结转移数大于 3个者单纯手术治疗与综合治疗 5年生存率分别为 0 %、12 5 % ,亦有差异性。结论 淋巴结转移状况是影响食管癌预后的重要因素 ,对有淋巴结转移的病人 。

Objective To study the situation of lymph node metastases of the esophageal carcinoma and its influence on patients' prognosis.Methods To analyse retrospectively the clinical material of 213 patients with esophageal cancer.Only operations on 148 patients.Combined treatment of 65 patients.192 cases of left thoracic approach intrathoracic esophagastrostomy.Left thoracotomy and cervical approach cervical esophagastrostomy 11 cases.Right thoracotomy posteriolateral,abdomen and cervical approach cervical esophagastrostomy 10 cases.Lymph node dissection was done in the operational field.To analyse the 5-year survival rate influenced by the lymph node metastases and different therapy.Results The 5-year survival rate of the patients with lymph node involvement is 16.1%,that of the patients without lymph node involvement is 54.6%.There exists a obvious difference of the patients with ≥3 involved lymph nodes,the 5-year survival rate is 0% to those who underwent resection only,and 12.5% to those who underwent combined treatment.There also exists the difference.Conclusions Lymph node metastases is the major factor affecting survival of patients with carcinoma of thoracic esophagus.Combined treatment is available to improve the therapeutic effect of the patient with lymph node metastases.