摘要
目的探讨淋巴结转移率(LNR)与食管鳞癌根治术后预后及术后辅助化疗的关系。方法采用回顾性病例对照研究方法。收集2012年1月至2016年9月北京大学肿瘤医院收治的121例行食管鳞癌根治术患者的临床病理资料;男105例,女16例;中位年龄为58岁,年龄范围为42~76岁。患者均行至少两野淋巴结清扫食管癌根治术。术后部分患者施行对应化疗和放疗。胸部和腹腔淋巴结分组参照美国癌症联合会(AJCC)第7版标准,清扫淋巴结按分组进行标记,清扫淋巴结均行病理学活组织检查。观察指标:(1)随访情况。(2)不同AJCC N分期中LNR对预后的影响。(3)LNR与术后辅助化疗的关系。采用门诊、电话和医院统计室查询方式进行随访,了解患者术后生存情况。随访时间截至2017年2月。无病生存时间为手术日至确认肿瘤复发的时间,总体生存时间为手术日至患者死亡或末次随访时间。偏态分布的计量资料以M(范围)表示,采用Kaplan-Meier法计算生存率和绘制生存曲线,采用Log-rank检验进行生存情况分析。结果(1)随访情况:121例患者术后均获得随访,随访时间为3.0~94.2个月,中位随访时间为27.1个月。随访期间,121例患者中98例肿瘤复发转移(64例死亡),22例未发生转移,1例肿瘤转移情况不详。患者总体生存时间平均为30.8个月,1、3、5年无病生存率分别为47.1%、20.3%、5.9%,1、3、5年总体生存率分别为93.1%、48.7%、35.3%。(2)不同AJCC N分期中LNR对预后的影响:121例患者中,46例N0期,42例N1期,28例N2期,5例N3期。42例N1期患者中,35例0<LNR≤0.15无病生存时间为12.2个月(1.2~82.3个月),7例LNR>0.15无病生存时间为6.9个月(2.1~23.1个月),两者比较,差异有统计学意义(χ^2=3.888,P<0.05)。28例N2期患者中,12例0<LNR≤0.15无病生存时间为8.5个月(1.2~38.8个月),16例LNR>0.15无病生存时间为4.4个月(1.0~52.7个月),两者比较,差异无统计学意义(χ^2=0.007,P>0.05)。46
Objective To investigate the relationship of lymph node metastasis rate (LNR) with prognosis of esophageal squamous cell carcinoma after radical resection and postoperative adjuvant chemotherapy. Methods The retrospective case-control study was conducted. The clinicopathological data of 121 patients who underwent radical resection of esophageal squamous cell carcinoma in the Peking University Cancer Hospital from January 2012 to September 2016 were collected. There were 105 males and 16 females, aged from 42 to 76 years, with a median age of 58 years. All patients underwent radical resection of esophageal cancer with at least two-field lymph nodes dissection. Some patients underwent corresponding chemotherapy and radiotherapy. The thoracic and abdominal lymph nodes were grouped according to the 7th edition standard of American Joint Committee on Cancer (AJCC). The lymph nodes dissected were labeled in groups, and all the lymph nodes were examined by pathology test. Observation indicators:(1) follow-up;(2) effects of LNR on prognosis of patients in different AJCC N staging;(3) relationship between LNR and postoperative adjuvant chemotherapy. Follow-up was conducted by outpatient examination, telephone interview and hospital statistical office to detect postoperative survival of patients up to February 2017. The disease-free survival time was from surgery date to date of confirmation of tumor recurrence, and the overall survival time was from surgery date to death of the patient or the last follow-up date. Measurement data with skewed distribution were expressed by M (range). The Kaplan-Meier method was used to calculate the survival rate and draw the survival curve. The Log-rank test was used for survival analysis. Results (1) Follow-up: 121 patients were followed up for 3.0-94.2 months, with a median follow-up time of 27.1 months. During the follow-up, 98 of 121 patients had tumor recurrence and metastasis (including 64 deaths), 22 had no metastasis, and 1 had unknown tumor metastasis. The mean overall survival t
作者
王方
贾军
杨颖
余靖
孙志伟
刘传玲
肖艳洁
杜丰
史幼梧
张晓东
Wang Fang;Jia Jun;Yang Ying;Yu Jing;Sun Zhiwei;Liu Chuanling;Xiao Yanjie;Du Feng;Shi Youwu;Zhang Xiaodong(VIP-Ⅱ Ward, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research of Ministry of Education, Beijing 100142, China;Department of Hematology and Oncology, the First Hospital of Tsinghua University, Beijing 100016, China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2019年第6期549-555,共7页
Chinese Journal of Digestive Surgery
关键词
食管肿瘤
食管鳞癌
淋巴结转移率
预后
辅助化疗
Esophageal neoplasms
Esophageal squamous cell carcinoma
Lymph node metastasis rate
Prognosis
Adjuvant chemotherapy
