目的 对食管癌手术患者进行生存分析。方法 选择南京市溧水区人民医院2012-05至2018-01手术治疗食管癌患者54例。随访方案:患者第1年每3~6个月复查1次,以后6~12个月复查1次,常规查胸上腹部CT。从病案管理科调阅食管癌手术信息,查阅电子病历HIS系统获取患者再入院诊疗信息,电话随访患者诊疗情况及生存状况,随访截止日期为2018-01-31。中位随访时间20个月。失访1例,随访率98.8%。统计患者1、3、5年无复发生存率和总生存率,采用COX回归模型分析影响患者生存率的因素。结果 54例患者1、3、5年无复发生存率分别为66.1%、58.1%和58.1%,总生存率分别为83.4%、61.8%和61.8%。食管癌总生存率与年龄(OR 3.848, 95% CI 1.047~14.143)及淋巴结是否转移(OR 4.777, 95% CI 1.165~19.594)有关,而与性别、吻合方式、肿瘤部位、分化、浸润全层、TNM分期、是否化疗无关。结论 食管癌患者术后总生存率与年龄及淋巴结是否转移有关,术后辅助化疗没有显示出明显优势。
Abstract
Objective To analyze the survival of patients with esophageal cancer.Methods Fifty-four patients with esophageal cancer were selected between May 2012 and January 2018 in Lishui People’s Hospital. Patients were reexamined every 3 to 6 months in the first year, followed by follow-ups every 6 to 12 months, and routine chest and abdominal CT was performed. Related information on surgery of esophageal cancer was retrieved from the department of medical records, electronic medical records were consulted from the HIS system to find out about the re-hospitalization of these patients, and the patients were followed up on the telephone asking about the therapeutic effect and survival. The follow-up deadline was January 31, 2018. The median duration of follow-up was 20 months. One case was later out of touch and the follow-up rate was 98.8%.Results The 1-year, 3-year and 5-year recurrence-free survival rates of these 54 patients were 66.1%, 58.1% and 58.1%, respectively. The overall survival rates were 83.4%, 61.8% and 61.8% respectively. The overall survival rate of esophageal cancer was related to age (OR 3.848, 95% CI 1.047-14.143)and lymph node metastasis(OR 4.777, 95% CI 1.165-19.594), but not to chemotherapy.Conclusions Total postoperative survival rate in patients with esophageal cancer is related to age and lymph node metastasis. Postoperative adjuvant chemotherapy fails to show any significant advantage.
关键词
食管癌 /
辅助化疗 /
总生存率
Key words
esophageal cancer /
adjuvant chemotherapy /
overall survival rate
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参考文献
[1] Pennathur A, Gibson M K, Jobe B A,et al. Oesophageal carcinoma [J]. Lancet,2013,381 (9864): 400-412.
[2] Shridhar R, Hayman T, Hoffe S E, et al. Body mass index and survival in esophageal adenocarcinoma treated with chemoradiotherapy followed by esophagectomy[J]. J Gastrointest Surg, 2012,16(7): 1296-1302.
[3] 李续源, 罗向三, 王鸿彪, 等. 胸段食管鳞癌手术治疗或根治性放化疗的复发和生存分析[J]. 肿瘤防治研究,2017,44(4): 286-289.
[4] Kelvin K, Chan W, Saluja R, et al. Neoadjuvant treatments for locally advanced, resectable esophageal cancer: A network meta-analysis [J]. Int J Cancer, 2018, 143(2): 430-437.
[5] Van Hagen P, Hulshof M C, Van Lanschot J, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer[J]. N Engl J Med, 2012, 366(22): 2074-2084.
[6] Almhanna K, Shridhar R, Meredith K L. Neoadjuvant or adjuvant therapy for resectable esophageal cancer: is there a standard of care? [J]. Cancer Control, 2013, 20(2): 89-96.
[7] Ychou M, Boige V, Pignon J P, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase Ⅲ trial [J]. J Clin Oncol, 2011, 29 (13): 1715-1721.
[8] Cunningham D, Allum W H, Stenning S P, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer[J]. N Engl J Med, 2006, 355(1):11-20.
[9] Tam V, Hooker C M, Molena D, et al. Clinical response to neoadjuvant therapy to predict success of adjuvant chemotherapy for esophageal adenocarcinoma[J]. J Clin Oncol, 2014,32: 137.
[10] Saeed N A, Mellon E A, Meredith K L,et al. Adjuvant chemotherapy and outcomes in esophageal carcinoma[J]. J Gastroint Oncol, 2017, 8(5): 816-824.
[11] 彭 进, 何栋成, 姚 蓉,等. 同步放化疗治疗食管癌术后复发的临床效果及预后因素分析[J]. 现代肿瘤医学,2015, 23(17):2442-2445.
[12] Guo Xufeng, Mao Teng, Gu Zhitao, et al. Clinical study on postoperative recurrence in patients with pN1 esophageal squamous cell carcinoma[J]. Thoracic Cancer, 2015, 6(2):146-150.
[13] Pasquer A, Gronnier C, Renaud F, et al. Impact of adjuvant chemotherapy on patients with lymph node-positive esophageal cancer who are primarily treated with surgery [J]. Ann Surg Oncol, 2015, 22 (Suppl 3): S1340-1349.
[14] 孙志伟,贾 军,杨 颖, 等. 晚期食管癌患者营养状态与化疗疗效及生存的相关性[J]. 肿瘤防治研究, 2017, 44(9):612-617.
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