摘要
目的分析术后化疗对术后淋巴结阳性胸段食管鳞癌患者预后的影响。方法回顾性分析419例胸段食管癌患者预后的影响因素。结果单纯手术患者1、3、5年OS显著低于术后化疗组(χ~2=12.802, P=0.000);而两组患者1、3、5年DFS差异未见统计学意义(χ~2=1.159, P=0.282)。多因素分析结果显示,性别、年龄、病变部位、TNM分期、术后化疗和化疗周期数为OS的独立性预后影响因素(P<0.05);而性别和N分期为DFS的独立性预后影响因素(P<0.05)。分层分析结果显示,相对于单纯手术,术后化疗可以提高男性、年龄≤60岁、胸中下段病变、病变长度≤5.0 cm和ⅢB期患者的OS(P<0.05),而且可以提高男性和年龄≤60岁患者的DFS(P<0.05)。结论术后淋巴结阳性胸段食管鳞癌患者预后较差,术后化疗可以提高部分患者的预后。
Objective To analyze the effect of postoperative chemotherapy(POCT) on the prognosis of postoperative lymph node-positive thoracic esophageal squamous cell carcinoma(TESCC) patients. Methods We retrospectively analyzed the prognostic factors for 419 lymph node-positive TESCC patients. Results Compared with POCT group, the 1-, 3-and 5-year OS was significantly lower in patients with surgery alone(χ2=12.802, P=0.000), while there was no significant difference in 1-, 3-or 5-year DFS(χ2=1.159, P=0.282). Multivariate analysis results showed that gender, age, location of lesion, TNM stage, POCT and chemotherapy cycles were the prognostic factors of OS(P〈0.05), and gender and N stage were the independent prognostic factors of DFS(P〈0.05). Hierarchical analysis results showed that POCT increased OS of male patients ≤60 years of age, lower thoracic lesions, lesions ≤5.0 cm and stage ⅢB, compared with surgery alone(P〈0.05), and also increased DFS of men ≤60 years of age(P〈0.05). Conclusion The prognosis of postoperative lymph node-positive TESCC patients is poor, POCT could improve the prognosis of some patients.
作者
沈文斌
高红梅
祝淑钗
李幼梅
李腾
李曙光
许金蕊
刘志坤
李娟
苏景伟
SHEN Wenbin;GAO Hongmei;ZHU Shuchail;LI Youmei;LI Teng;LI Shuguang;XU Jinrui;LIU Zhikun;LI Juan;SU Jingwei(Department of Radiation Oncology,The Fourth Hospital,Hebei Medical University,Shij'iazhuang 050011,China;Department of Radiation,The First Hospital of Shijiazhuang,Shijiazhuang 050011,China)
出处
《肿瘤防治研究》
CAS
CSCD
2018年第10期762-767,共6页
Cancer Research on Prevention and Treatment
关键词
食管鳞癌
手术治疗
辅助化疗
预后
Esophageal squamous cell carcinoma
Surgical treatment
Adjuvant chemotherapy
Prognosis