外科治疗Ⅲ期食管癌患者的生存状况研究

Survival situation of surgical treatment of stage Ⅲ esophageal cancer patients

摘要:

探讨外科治疗Ⅲ期食管癌患者的生存状况。方法回顾性分析96 例食管癌患者的临床资料，根据随访结果，统计Ⅲ期食管癌患者的1、3 及5 年生存率，并根据患者5 年生存状况将患者分为生存组和死亡组，比较两组患者的性别、年龄、手术方式、肿瘤直径、病理类型、是否合并慢性疾病、病理残端切除方式、是否淋巴结转移、是否合并脉管瘤栓、T分期、N分期、TMN分期及术后辅助治疗方式，确定手术治疗食管癌患者5 年生存率的相关影响因素和独立影响因素，并进一步确定不同术后辅助治疗方式患者的5年生存率。结果96例患者1 年生存率74.0%（71/96），3 年生存率33.3%（32/96），5 年生存率为26.0%（25/96），患者平均生存时间为24.1 个月；确定手术方式、肿瘤部位、N 分期、TMN 分期及术后辅助治疗方式为外科治疗Ⅲ期食管癌患者的5年生存率的相关影响因素；确定TMN分期、术后辅助治疗方式为外科治疗Ⅲ期食管癌患者5 年生存率的独立影响因素；Ⅲa 患者术后接受不同辅助治疗5 年生存率的差异具有统计学意义，Ⅲb 和Ⅲc患者术后接受不同辅助治疗5 年生存率的差异无统计学意义。结论TMN分期、术后辅助治疗方式为外科治疗Ⅲ期食管癌患者5年生存率的独立影响因素。对于临床分期越晚的患者，5 年生存率越低，术后放化疗可以有效的提升患者的生存状况。

Abstract:

To explore the survival status of surgical treatment of stage Ⅲ esophageal cancer. Methods The clinical data of 96 patients with esophageal cancer were analyzed retrospectively. According to the follow-up results, the 1 year, 3-year and 5-year survival rate of esophageal cancer were collected. The patients were divided into survival group and death group according to their living condition for 5 years. The sex ratio, age distribution, operation style, tumor diameter, pathologic type, chronic disease and pathologic stump resection were compared between the two groups. T staging, N staging, TMN staging and postoperative adjuvant therapy were used to determine the factors influencing 5-year survival rate of patients with gallbladder carcinoma after operation. The factors influencied the 5-year survival rate of gallbladder carcinoma were determined. Results The 1-year survival rate was 74.0% (71/96), 3-year survival rate was 33.3% (32/96), 5-year survival rate was 26.0% (25/96), and the mean survival time was 24.1 months. The surgical approach,the tumor site, N stage, TMN staging and adjuvant treatment were relevant factors in the surgical treatment of 5-year survival of patients with esophageal cancer Ⅲ. TMN stage and postoperative adjuvant therapy were the independent influencing factors of 5-year survival rate in patients with stage Ⅲesophageal cancer. There were statistically difference in the 5-year survival rate of patients with stage Ⅲa after receiving differentadjuvant therapy. There was no significant difference in the survival rate of patients with Ⅲb and Ⅲc after 5 years of different adjuvant therapy. Conclusions TMN staging and postoperative adjuvant therapy are the independent prognostic factors for the 5-year survival rate of patients with stage Ⅲesophageal carcinoma. For the late clinical stage of patients, 5-year survival rate is lower, postoperative radiotherapy and chemotherapy can effectively improve the survival of patients.