外科治疗食管、贲门癌预后与年龄的关系

The Relationship Between the Age at the Time of Surgery and the Prognosis for Carcinoma of the Esophagus and Gastric Cardia

目的 回顾性研究了手术切除食管癌和贲门癌的病人 ,评价了手术时的年龄与预后的关系。方法 从 1983年到 1995年 ,我科共手术切除食管癌和贲门癌 14 49例 ,将病人按手术时的年龄分成 7个组 ,然后根据病人的性别 ,年龄分别计算其生存率 ,使用图表法进行对比。结果 通过比较我们发现年龄小于 40岁和大于 70岁的病人其总的预后是差的 ,而 40～ 70岁之间的病人 ,其五年生存率差别不大。 <3 0岁 ,3 0～ 3 9岁 ,40～ 49岁 ,5 0～ 5 9岁 ,60～ 69岁 ,70～ 79岁和 >80岁的病人 ,五年生存率分别是 7 5 % ,10 3 % ,3 0 6% ,3 7 1% ,3 4 2 % ,13 4%和 0 0 %。结论 年轻病人预后差的原因可能是肿瘤的分化差 ,转移发生较快 ,姑息性手术比率较高有一定的关系 ,而高龄病人长期生存率低可能与其它疾病导致死亡率增高有关。因此 ,我们认为对食管癌和贲门癌病人行手术治疗时 ,特别对于年轻或高龄病人 ,年龄是一个预后因素。

Objective The purpose of the study was to determine the long-time prognosis of age-classified groups of patients with carcinoma of the esophagus and gastric cardia.All of them underwent esophagogastrectomy.Methods The 1 449 patients were entered in the study.The patients were divided into 7 groups according to their ages at time of surgery.We calculated survival rates related to carcinoma of the esophagus and gastric cardia and the other diseases.Results The overall prognoses of patients under age of 40 and over age of 70 years were poor.<of the age under 30 years,30～39,40～49,50～59,60～69,70～79 and over 80 years,the 5-years survival rates were 7.5%,10.3%,30.6%,37.1%,34.2%,13.4% and 0.0% respectively.Conclusions We've concluded that the poor prognosis of the youngest patients could be attributed to a high frequency of aggressive stage of the tumor.The poor prognosis of the oldest patients were attributed to the number of deaths due to other diseases.The study shows that as for the very young or old subjects,age is a significant prognostic factor for those treated by esophagogastrectomy for carcinoma of the esophagus and cardia.