| 谢良喜,周礼雅,谢文佳.食管—胃交界癌根治术后的疗效观察及预后因素分析[J].肿瘤学杂志,2013,19(10):787-791. |
| 食管—胃交界癌根治术后的疗效观察及预后因素分析 |
| Clinical Efficacy and Prognostic Factors of Patients with Esophagogastric Junction Adenocarcinoma (EGJA) After Radical Resection |
| 投稿时间：2013-05-23 |
| DOI：10.11735/j.issn.1671-170X.2013.10.B010 |
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| 中文关键词: 食管—胃交界肿瘤 根治性切除术 预后 Cox比例风险模型 |
| 英文关键词:esophagogastric junction adenocarcinoma radical resection prognosis Cox proportional hazard model |
| 基金项目:国家自然科学基金（81171994）和广东省自然科学基金 |
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| 中文摘要: |
| 摘 要：［目的］ 回顾性分析食管—胃交界癌根治术后患者的远期生存情况，并探讨其预后影响因素。［方法］ 收集2000年10月至2002年10月间行食管—胃交界癌根治术治疗的137例患者的临床病理资料，对所有患者治疗结果进行随访。Kaplan-Meier法行生存分析，Cox比例风险模型筛选独立的预后影响因素。［结果］ 本组患者平均生存时间为（38.0±2.52）个月，中位生存时间为25个月； 5年总生存率和无瘤生存率分别为32.9%、32.5%。单因素分析结果显示临床分期、T分期、N分期、性别、年龄、肿瘤最长径、术后化疗、清扫淋巴结总数、上瘤距、下瘤距对治疗预后有显著影响。Cox多因素分析显示T分期、N分期、术后化疗、下瘤距、清扫淋巴结总数为独立的预后影响因素。［结论］ 术后辅助化疗可明显提高患者生存期。肿瘤切除范围包括7cm以上正常食管和胃组织，可避免绝大多数切缘阳性。食管—胃交界癌根治术淋巴结清扫多于9枚患者有明显生存获益。 |
| 英文摘要: |
| Abstract: ［Purpose］ To evaluate the clinical efficacy and to explore the independent prognostic factors of patients with esophagogastric junction adenocarcinoma (EGJA) after Radical resection. ［Methods］ The clinical and pathological data of 137 patients with EGJA underwent Radical resection from October 2000 to October 2002 were analyzed retrospectively. All patients had been followed up for at least 5 years. Univariate analysis(Kaplan-Meier method) was used for survival analysis. For those statistically significant factors in univariate analysis，multivariate analysis (Cox Proportional Hazard Model) was performed to explore the independent prognostic factors. ［Results］ The mean follow-up time for the whole group was (38.0±2.52) months; 5-year overall survival (OS) rate，disease-free survival (DFS) rate were 32.9% and 32.5%，respectively. In univariate analysis，significant prognostic factors for OS were T stage，N stage，sex，age，tumor size，chemotherapy，total number of dissected lymph nodes，upper and lower distance of tumor to margins. Cox Proportional Hazard Model showed that T stage，N stage，chemotherapy，lower distacnce of tumor to margin，numbers of dissected lymph nodes were independent prognostic factors for overall survival. ［Conclusions］ Postoperative chemotherapy improves the long-term survival and thus remains a better management for EGJA. Adequate resection margins should include at least 7cm of normal esophagus tissue and 7cm of normal stomach tissue to avoid tumor residence. At least 9 lymph nodes should be dissected for pathological examination to assure adequate removal of the regional lymph node. |
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