胸部食管癌转移淋巴结数与预后的临床研究

目的 探讨胸部食管癌转移淋巴结的个数与预后的关系。方法 采用颈、胸、腹三切口施行胸部食管癌手术１１２例，同时施行三区域淋巴结清扫。选择９个可能对食管癌切除术后预后产生影响的特征性临床因素，通过Ｃｏｘ比例风险模型，利用累计生存率对食管癌切除术后患者进行预后多因素分析。结果 本组总５年生存率为５８．４％，其中无淋巴结转移组（Ａ组）为８８．４％、转移淋巴结１～３枚组（Ｂ组）为５０．８％，转移≥４枚组（Ｃ

The number of lymph node with metastases influences survival in patients with cancer of the thoracic esophagus

OBJECTIVE: To study the extent of lymph node involvement in relation to survival of patients with thoracic esophageal carcinoma. METHODS: From 1990 to 1993, there were 112 patients with thoracic esophageal carcinoma undergone esophagectomy through right thoracotomy and three-field lymphadenectomy. They were classified into three groups: group A, 44 patients without lymph node involvement; group B, 36 patients with 1 to 3 positive nodes; group C, 32 patients with > or = 4 involved lymph nodes. Nine possible factors influencing survival were studied. A multivariate analysis of these variables was performed using the cumulative survival rate by the computer's Cox proportional hazard model. RESULTS: The over-all cumulative survival rate was 58.4% at 5 years. That for patients in group A, B and C was 88.4%, 50.8% and 20.8%, respectively. Apart from the extent of lymph node metastases, depth of tumor invasion, location and differentiation of tumor were of prognostic significance. CONCLUSION: Lymph node metastasis is the major factor affecting survival of patients with cancer of the thoracic esophagus.