背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关...背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关预后因素。方法:回顾性分析1996年1月1日-2005年9月31日间复旦大学附属肿瘤医院腹部外科收治的749例可切除的AGEJ病例的临床和病例资料,并对其进行随访。AJCC分期:Ⅰ期90例(12.0%),Ⅱ期165例(22.0%),Ⅲ期379例(50.6%),Ⅳ期115例(15.4%)。手术根治率89.5%,R0根治切除率87.4%。生存率计算及生存曲线绘制采用Kaplan-Meier法,单因素预后分析采用Log-rank检验,多因素预后分析采用Cox比例风险模型。结果:本组病例的总体5年生存率为38.5%,中位生存期为38个月。手术性质、淋巴结清扫范围、胃体切除范围、联合胰脾切除、大体标本类型、肿瘤累及贲门、肿瘤部位、肿瘤最大径、分化程度、脉管侵犯、淋巴结阳性比、阳性切缘、肿瘤残留分级以及TNM分期在单因素分析中显示对预后有显著影响。胸腹联合手术与单纯进腹手术预后差异无统计学意义(38.3%vs40.1,P=0.850)。多因素分析结果显示肿瘤残留分级、脉管累及、淋巴结阳性比及TNM分期是独立的预后因素。结论:AGEJ的外科治疗中,手术入路的选择不影响患者的预后。手术应行标准D2淋巴清扫,并达到R0根治切除。联合胰脾切除疗效有待临床验证。病理检查中,应尽可能检出16枚以上的淋巴结,以保证分期的准确性。展开更多
To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer （PCa）. We retrospectively analysed 115 PCa patients with bone metastases between 1997 an...To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer （PCa）. We retrospectively analysed 115 PCa patients with bone metastases between 1997 and 2009. The overall survival rate after bone metastases was calculated using the Kaplan-Meier method. The prognostic factors were identified by univariate analysis using a log-rank test and by multivariate analysis using Cox proportional hazards regression models. The follow-up rate was 100%, the follow-up cases during 1, 3 and 5 years were 103, 79 and 55, respectively. The 1-, 3- and 5-year survival rates were 89.1%, 60.9% and 49.8%, respectively, with a median survival time of 48.5 months for patients with bone metastases from PCa. In univariate analysis, age, Gleason score, clinical stage, the number of bone lesions, alkaline phosphatase （ALP） level, invasion of neighbouring organs and non-regional lymph node metastases were correlated with prognosis. By multivariate analysis using Cox regression, ALP level, Gleason score and non-regional lymph node metastases were independent prognostic factors. These prognostic factors will help us to determine the appropriate dose and fraction of radiotherapy for these patients.展开更多
文摘背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关预后因素。方法:回顾性分析1996年1月1日-2005年9月31日间复旦大学附属肿瘤医院腹部外科收治的749例可切除的AGEJ病例的临床和病例资料,并对其进行随访。AJCC分期:Ⅰ期90例(12.0%),Ⅱ期165例(22.0%),Ⅲ期379例(50.6%),Ⅳ期115例(15.4%)。手术根治率89.5%,R0根治切除率87.4%。生存率计算及生存曲线绘制采用Kaplan-Meier法,单因素预后分析采用Log-rank检验,多因素预后分析采用Cox比例风险模型。结果:本组病例的总体5年生存率为38.5%,中位生存期为38个月。手术性质、淋巴结清扫范围、胃体切除范围、联合胰脾切除、大体标本类型、肿瘤累及贲门、肿瘤部位、肿瘤最大径、分化程度、脉管侵犯、淋巴结阳性比、阳性切缘、肿瘤残留分级以及TNM分期在单因素分析中显示对预后有显著影响。胸腹联合手术与单纯进腹手术预后差异无统计学意义(38.3%vs40.1,P=0.850)。多因素分析结果显示肿瘤残留分级、脉管累及、淋巴结阳性比及TNM分期是独立的预后因素。结论:AGEJ的外科治疗中,手术入路的选择不影响患者的预后。手术应行标准D2淋巴清扫,并达到R0根治切除。联合胰脾切除疗效有待临床验证。病理检查中,应尽可能检出16枚以上的淋巴结,以保证分期的准确性。
文摘To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer （PCa）. We retrospectively analysed 115 PCa patients with bone metastases between 1997 and 2009. The overall survival rate after bone metastases was calculated using the Kaplan-Meier method. The prognostic factors were identified by univariate analysis using a log-rank test and by multivariate analysis using Cox proportional hazards regression models. The follow-up rate was 100%, the follow-up cases during 1, 3 and 5 years were 103, 79 and 55, respectively. The 1-, 3- and 5-year survival rates were 89.1%, 60.9% and 49.8%, respectively, with a median survival time of 48.5 months for patients with bone metastases from PCa. In univariate analysis, age, Gleason score, clinical stage, the number of bone lesions, alkaline phosphatase （ALP） level, invasion of neighbouring organs and non-regional lymph node metastases were correlated with prognosis. By multivariate analysis using Cox regression, ALP level, Gleason score and non-regional lymph node metastases were independent prognostic factors. These prognostic factors will help us to determine the appropriate dose and fraction of radiotherapy for these patients.
