论文部分内容阅读
目的探讨影响中老年(50岁以上)食管鳞癌患者术后生存和预后的因素。方法回顾性分析食管癌患者临床病理因素和随访资料,通过Kap lan-M e ier曲线和Cox多因素回归模型分析评估与生存相关因素。结果中老年食管鳞癌患者5年生存率为28.37%。单因素分析显示年龄、分化程度、体重减轻、术前并发症、病变长度、手术方式、浸润深度、淋巴结转移、术后临床分期、术前低蛋白、术前放化疗与5年生存率有关(P<0.05);多因素分析显示淋巴结转移、术前低蛋白、分化程度、病变长度、手术方式、浸润深度、临床分期、术前放化疗等是影响中晚期食管鳞癌预后的独立因素(P<0.05)。结论中老年食管癌多数属于中晚期,根治性手术切除有一定难度,在可耐受情况下,积极行术前放化疗可以提高生存率。而术前低蛋白、分化程度、浸润深度、手术方式、淋巴结转移、临床分期等可能预测患者预后。
Objective To explore the factors influencing the postoperative survival and prognosis of esophageal squamous cell carcinoma in middle-aged and elderly patients (over 50 years old). Methods The clinical and pathological factors and follow-up data of patients with esophageal cancer were retrospectively analyzed. Kaplan-Meier curves and Cox regression model were used to evaluate the factors related to survival. Results The 5-year survival rate of esophageal squamous cell carcinoma was 28.37%. Univariate analysis showed that age, degree of differentiation, weight loss, preoperative complications, pathological length, surgical approach, depth of invasion, lymph node metastasis, clinical staging, preoperative low protein, preoperative radiotherapy and 5-year survival rate P <0.05). Multivariate analysis showed that lymph node metastasis, preoperative low protein, degree of differentiation, length of lesion, operation method, depth of invasion, clinical stage and preoperative chemoradiotherapy were independent prognostic factors of advanced esophageal squamous cell carcinoma (P <0.05). Conclusion The majority of middle-aged and elderly patients with esophageal cancer are in the advanced stage. Radical resection has some difficulties. In tolerable cases, aggressive preoperative chemoradiotherapy can improve the survival rate. Preoperative low protein, differentiation, depth of invasion, surgical methods, lymph node metastasis, clinical stage may predict the prognosis of patients.