辅助疗法对食管鳞癌患者预后的影响

Effect of adjuvant therapy on prognosis of patients with esophageal squamous cell carcinoma

摘要:

目的 探讨辅助疗法对N1 期食管鳞癌患者外科治疗后生存状况的影响。方法 选取2009 年3 月- 2013 年2 月齐齐哈尔医学院附属第三医院收治的N1 期食管鳞癌患者136 例，依据治疗方案分为单纯手术组（57 例）和辅助疗法组（79 例），比较两组患者的生存状况，并对入组患者的临床资料进行单因素和多因素Cox 比例风险模型分析。结果 辅助疗法组患者的中位无病生存时间和中位总生存时间高于单纯手术组（P <0.05）。 男性、ECOG 评分>2 分、肿瘤直径>5 cm、低分化、术前血红蛋白>135 g/L、颈部吻合、淋巴结转移、脉管 瘤栓、神经侵犯、未接受辅助治疗的患者的中位生存时间较低，诸多因素与N1 期食管鳞癌患者外科治疗后的 生存状况有关（P <0.05）。ECOG 评分>2 分、低分化、未接受辅助治疗是影响N1 期食管鳞癌患者外科治疗 后生存状况的危险因素（P <0.05）。结论 辅助疗法能够延长N1 期食管鳞癌患者外科治疗后的生存时间，是 影响患者生存状况的独立危险因素。

Abstract:

Objective To evaluate the effect of adjuvant therapy on the survival status of stage N1 esophageal squamous cell carcinoma after surgical treatment. Methods Totally 136 patients with stage N1 esophageal squamous cell carcinoma in our hospital from March 2009 to February 2013 were selected, and divided into simple operation group (57 cases) and adjuvant therapy group (79 cases) according to the treatment regimen. The survival status of the two groups was compared, and the clinical data of the patients were analyzed by univariate and multivariate COX proportional hazards model. Results The median disease-free survival time and median overall survival time of the patients in the adjuvant therapy group were significantly longer than those in the simple surgery group (P < 0.05). The median survival time was shorter in the male patients and the patients with ECOG score >2 points, tumor diameter >5 cm, poor differentiation, preoperative hemoglobin >135 g/L, cervical anastomosis, lymph node metastasis, vascular tumor embolus, nerve invasion or non-adjuvant therapy (P < 0.05), and multiple factors were associated with survival status of the patients after surgical treatment for stage N1 esophageal squamous cell carcinoma (P < 0.05). ECOG score >2 points, poor differentiation, and no adjuvant therapy were the risk factors of the survival status of the patients with stage N1 esophageal squamous cell carcinoma after surgical treatment (P < 0.05). Conclusions Adjuvant therapy can prolong the survival time of the patients with stage N1 esophageal squamous cell carcinoma after surgical treatment, and is an independent risk factor affecting the survival of the patients.