非手术治疗食管癌的临床分期研究

目的 验证中国非手术治疗食管癌临床分期专家小组制定的非手术治疗食管癌临床分期标准的临床指导意义,进一步探讨非手术治疗食管癌的预后相关因素,为下一步的分期标准修订提供依据.方法 回顾性分析542例经非手术治疗的食管鳞癌患者的临床资料和随访资料,按照中国非手术治疗食管癌临床分期专家小组制定的临床分期标准进行分期,分析不同分期下的生存情况.结果 542例患者1、3、5年生存率分别为86.8％、63.2％、47.3％.不同临床分期的患者比较,总生存时间差异有统计学意义(P＜0.0001).上段食管癌非手术治疗生存期好于中段和下段,差异均有统计学意义(P值分别为0.000和0.004).不同病理分化程度比较,生存差异同样具有统计学意义(P=0.019).结论 中国食管癌专家组制定的非手术治疗食管癌的临床分期标准,能够较好地估计预后.不同解剖部位和病理分化程度也应作为临床分期的因素予以考虑.

Study of Clinical Staging of Esophageal Cancer Treated by Non-surgical Methods

ObjectiveTo evaluate the effects of Chinese criteria of clinical staging system for esophageal cancer in the treatment of non-surgical esophageal cancer,and investigate the other factors influenced on prognosis of non-surgical esophageal cancer.Methods
All with esophageal squamous cell cancer retrospectively 542 patients were divided into different stages according to the Chinese criteria of clinical staging system for esophageal cancer.OS was analyzed by Kaplan-Meier curves.ResultsAmong the 542 cases,the 1-,3-,5-year survival rates were 86.8%,63.2% and 47.3%,respectively.Significant differences(P=0.000)were shown in different TNM stages.Upper esophageal disease had better prognosis than middle and lower disease(P=0.000 and 0.004).Pathology differentiations were also a factor impacted on the prognosis (P=0.019).ConclusionThe Chinese criteria of clinical staging system for esophageal cancer were adaptable to predict prognosis of esophageal squamous cell cancer treated by non-surgical therapy.Anatomic site and Pathology differentiation should also be considered in the staging system.