行根治术治疗食管癌和贲门癌患者的预后分析

目的 探讨食管癌和贲门癌患者行根治术治疗后的预后影响因素.方法 回顾性分析906例行根治术治疗的食管癌和贲门癌患者的临床资料,选择12个可能对患者预后产生影响的特征性临床病理因素,运用Cox比例风险模型进行预后分析.结果 906例患者的1、3、5年累积生存率分别为89.8%、75.4%和71.7%.单因素分析结果显示,年龄、病理类型、病变长度、淋巴结转移数、临床分期、浸润深度、周围器官受侵情况与行根治手术治疗的食管癌和贲门癌患者的预后有关.Cox比例风险模型多因素分析结果显示,病理类型、临床分期、淋巴结转移数、周围器官受侵情况为行根治手术治疗的食管癌和贲门癌患者预后的独立影响因素.结论 病理类型、临床分期、淋巴结转移数、周围器官受侵情况为行根治手术治疗的食管癌和贲门癌患者预后的独立影响因素,临床医师在实际工作中可以参考借鉴.

Cox proportional hazard model analysis of prognosis in patients with carcinoma of esophagus and gastric cardia after radical resection

Objective To investigate the factors affecting the long-term survival of patients with carcinoma of esophagus and gastric cardia after curative resection. Methods The clinical data of 906 patients with carcinoma of esophagus and gastric eardia treated by radical resection in 1996-2004 were analyzed retrospectively. Twelve elinicopathologieal factors possibly influencing survival were encoded and assessed by Cox regression analysis. Results The 1-, 3- and 5-year cumulative survival rates were 89.8% , 75.4% and 71.7%, respectively. The univariate analysis showed that age, length of tumor, pathological differentiation, number of metastatic lymph nodes, depth of invasion, involvement of adjacent organs and the TNM stage influenced the prognosis significantly (P <0.01 ). However, multivariate analysis showed that pathologic differentiation, number of metastatic lymph nodes, involvement of adjacent organs and TNM stage were independent prognostic factors ( P < 0.05 ). Conclusion The independent prognostic factors of the patients with carcinoma of esophagus and gastric eardia are pathologic differentiation, TNM stage, number of metastatic lymph nodes, and involvement of adjacent organs. The other factors influencing survival are age, length of tumor and depth of invasion. Furthermore, invasion of adjacent organs suggests worse prognosis, and should be followed-up closely.