食管癌食管支架置入术患者的预后及影响因素分析

目的:探讨食管支架置入术(esophageal stenting)治疗恶性食管狭窄的预后及其影响因素。方法:对2004～2009年行食管支架置入术的91例食管癌患者进行随访,随访时间1～60个月,随访率为95.6%。分析8项可能影响生存率的因素,探讨其与生存率的相关性。生存率影响因素的单因素分析采用Kaplan-Meier模型及Log-rank检验,多因素分析采用COX比例风险模型。结果:全组患者置入食管支架后的半年、1年、3年和5年生存率分别是55.9%、27.8%、14.9%和8.6%,中位生存期为8.1个月。可能影响生存率的8项单因素中,3项有统计学意义,分别为肿瘤UICC分期、根治性手术史和是否合并食管瘘(均P<0.05)。与生存率相关的多因素有3项,分别为肿瘤UICC分期、根治性手术史和是否合并食管瘘(均P<0.05)。结论:食管支架置入术治疗恶性食管狭窄的短期疗效好,但中长期疗效较差。其预后影响因素为肿瘤UICC分期、根治性手术史和是否合并食管瘘,此结果有助于指导食管支架置入术在食管癌综合治疗中的应用。

Prognosis of patients with esophageal neoplasms after undergoing esophageal stenting surgery and its influencing factor

Objective: To explore the prognosis of patients with esophageal neoplasms after undergoing esophageal stenting surgery and its influencing factors.Methods: A total of 91 patients with malignant esophageal stenosis underwent esophageal stenting from 2004 to 2009 were enrolled.The follow-up lasted for 1 to 60 months and the follow-up rate was 95.6%.Eight possible risk factors affecting survival rate were analyzed,and the relationship between these factors and survival rate was also analyzed.Univariate analysis of risk factors was analyzed by Kaplan-Meier model and Log-rank test and multivariate analysis was analyzed by COX regression model.Results: The survival rate at half a year,1 year,3 year and 5 year was 55.9%,27.8%,14.9% and 8.6%,respectively.Medial survival time was 8.1 months.Three of eight possible risk factors were found significant,including UICC stage,history of radical resection and esophageal fistula(All P<0.05).Conclusions: Esophageal stenting is effective in short term on the treatment of malignant esophageal stenosis,but it is poor in mid-long term outcome.UICC stage,history of radical resection and esophageal fistula are risk factors.This study is useful in the synthetic treatment of esophageal neoplasms.