| 褚嘉栋,楼丽姝,王长春,等.基于医院登记数据的2 598例食管癌患者术后长期生存及预后因素分析[J].中国肿瘤,2026,35(2):103-109. |
| 基于医院登记数据的2 598例食管癌患者术后长期生存及预后因素分析 |
| A Long-Term Survival and Prognostic Factors Analysis of 2 598 Patients with Esophageal Cancer Undergoing Surgery Based on Hospital Registration Data |
| 投稿时间：2025-09-16 |
| DOI：10.11735/j.issn.1004-0242.2026.02.A004 |
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| 中文关键词: 食管癌 外科手术 总生存率 生存随访 医院登记 |
| 英文关键词:esophageal cancer surgery overall survival rate survival follow-up hospital registration |
| 基金项目:江西省卫健委科技创新重点项目（20242D008） |
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| 中文摘要: |
| 摘 要：［目的］ 基于医院登记数据，分析食管癌手术患者的长期生存状况及预后影响因素，为临床诊疗提供真实世界证据。［方法］ 纳入2015年1月1日—2021年12月31日在浙江省肿瘤医院接受根治性手术的食管癌患者2 598例，收集患者基本信息、临床特征以及随访生存数据。随访至2024年11月，采用Kaplan-Meier法计算1、3、5年总生存（overall survival，OS）率，Log-rank检验比较亚组差异。［结果］ 中位随访5.18年，全组1、3、5年OS率分别为87.02%、64.14%、55.55%。病理分期是重要预后因素，0~Ⅳ期5年OS率依次为94.44%、75.22%、62.94%、38.05%、12.72%（P<0.001）；女性、<75岁、腔镜手术、三切口术式及高分化鳞癌患者生存更具优势（P均<0.05）。2019—2020年手术患者5年OS率（59.47%）高于2015—2016年（52.13%）和2017—2018年（50.13%）（P<0.001），行新辅助治疗后再手术组与直接手术组总体OS率差异无统计学意义（P=0.074）。［结论］ 病理分期、性别、年龄、手术方式及肿瘤病理特征是食管癌患者术后重要预后影响因素。规范化治疗及早筛早诊可进一步改善患者生存。 |
| 英文摘要: |
| Abstract：［Purpose］ To evaluate the long-term survival status and prognostic factors of esophageal cancer patients who underwent surgical treatment based on hospital registration data， and provide the latest real-world evidence for clinical diagnosis and treatment. ［Methods］ A total of 2 598 patients with esophageal cancer who received radical surgical treatment in Zhejiang Cancer Hospital from January 1， 2015 to December 31， 2021 were enrolled. Basic patient information， clinical characteristics and follow-up survival data were collected， with follow-up conducted until November， 2024. The Kaplan-Meier method was used to estimate the 1-year， 3-year and 5-year overall survival (OS) rates after surgery， and the Log-rank test was used to compare survival difference among subgroups. ［Results］ After a median follow-up of 5.18 years， the 1-year， 3-year， and 5-year OS rates of the entire cohort were 87.02%， 64.14%， and 55.55%， respectively. Pathological stage was the significant prognostic factor， with the 5-year OS rates of stage 0 to Ⅳ being 94.44%， 75.22%， 62.94%， 38.05%， and 12.72% sequentially (P<0.001). Female patients， younger patients (<75 years old)， those who underwent laparoscopic surgery， three-incision surgery， and patients with well-diffe-rentiated squamous cell carcinoma showed more favorable survival outcomes (all P<0.05). The 5-year OS rate of patients who underwent surgery during 2019—2020 (59.47%) was higher than that of patients during 2015—2016 (52.13%) and during 2017—2018 (50.13%) (P<0.001). There was no statistically significant difference in the overall OS rate between the neoadjuvant therapy group and the direct surgery group(P=0.074). ［Conclusion］ Pathological stage， sex， age， surgical method， and tumor pathological characteristics are important prognostic factors. Standardized treatment as well as early screening and diagnosis can further improve the survival of patients. |
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