摘要
目的探讨pT2~3N0M0胸段食管鳞癌患者术后的生存状况及影响因素。方法回顾性分析2011年6月至2017年6月行单纯根治性手术的175例pT2~3N0M0患者的临床资料。分析不同纳入因素(性别、年龄、病变部位、病变长度、病变宽度、病理T分期、分化程度、神经侵犯状态、脉管癌栓及淋巴结清扫数目)对总生存时间(OS)和无病生存时间(DFS)的影响。生存分析采用Kaplan-Meier法,预后多因素分析采用Cox比例风险回归模型。结果全组患者的1、3、5年生存率为88.6%、58.3%、47.3%,中位OS为49.0个月;1、3、5年无病生存率为74.8%、36.6%、23.9%,中位DFS为24.0个月。Cox多因素分析显示,病理T分期(HR=1.620,95%CI:1.075~2.441)和神经侵犯状态(HR=5.778,95%CI:2.718~12.283)是影响OS的独立因素(P<0.05);病理T分期(HR=1.547,95%CI:1.080~2.216)、神经侵犯状态(HR=2.930,95%CI:1.403~6.117)和病变部位(中段vs.上段:HR=0.561,95%CI:0.334~0.944;下段vs.上段:HR=0.436,95%CI:0.221~0.859)是影响DFS的独立因素(P<0.05)。结论病理T分期和神经侵犯状态是影响pT2~3N0M0胸段食管鳞癌患者术后OS及DFS的独立因素,病变部位亦是影响DFS的独立因素。
Objective To investigate the survival and prognostic factors for thoracic esophageal squamous cell carcinoma(TESCC)with stage pT2-3N0M0 after radical surgery.Methods From June 2011 to June 2017,175 TESCC patients with pathological T2-3N0M0 underwent radical surgery without perioperative therapies were enrolled in this study.The influencing factors,including sex,age,location of tumor,length of tumor,width of tumor,pathological T stage,differentiation,perineural invasion,vessel invasion and number of resected lymph nodes on overall survival(OS)and disease-free survival(DFS)was analyzed.The Kaplan-Meier method was used for survival analysis.Multivariate factors analysis was performed by Cox proportional hazard regression model.Results The median OS was 49.0 months,and the1-,3-,5-year survival rates were 88.6%,58.3%and 47.3%,respectively.The median DFS was 24.0 months,and the 1-,3-,5-year disease-free survival rates were 74.8%,36.6%and 23.9%,respectively.The Cox regression analysis indicated that the T stage(HR=1.620,95%CI:1.075-2.441)and perineural invasion(HR=5.778,95%CI:2.718-12.283)were independent factors influencing OS,and T stage(HR=1.547,95%CI:1.080-2.216),perineural invasion(HR=2.930,95%CI:1.403-6.117)and location of tumor(middle vs.upper TESCC:HR=0.561,95%CI:0.334-0.944;lower vs.upper TESCC:HR=0.436,95%CI:0.221-0.859)were independent factors influencing DFS.Conclusion Pathological T stage and perineural invasion are independent factors for OS and DFS.The location of tumor is also an independent factor for DFS.
作者
朱礼阳
陈东波
夏万里
康宁宁
康梅
张丽
汪义纯
ZHU Liyang;CHEN Dongbo;XIA Wanli;KANG Ningning;KANG Mei;ZHANG Li;WANG Yichun(Department of Radiation Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China)
出处
《临床肿瘤学杂志》
CAS
北大核心
2020年第11期993-998,共6页
Chinese Clinical Oncology
关键词
食管鳞癌
根治术
预后
pT2-3N0M0
Esophageal squamous cell carcinoma
Radical surgery
Prognosis
pT2-3N0M0
