胸段食管鳞癌手术治疗或根治性放化疗后复发和生存分析

李绪渊; 罗何三; 王鸿彪; 徐绮腻; 杜泽森

doi:10.3971/j.issn.1000-8578.2017.04.010

胸段食管鳞癌手术治疗或根治性放化疗后复发和生存分析

Recurrence and Survival of Thoracic Esophageal Squamous Cell Carcinoma Treated with Surgery or Definitive Chemoradiation Therapy

摘要

摘要:
目的分析经手术治疗或根治性放化疗的胸段食管鳞癌患者的复发部位和生存时间特征。
方法回顾性分析胸段食管鳞癌患者的复发和生存时间，应用Kaplan-Meier法分析生存时间，Cox回归模型进行多因素预后分析。
结果本研究纳入586例胸段食管鳞癌患者，其中手术组334例，放化疗组252例。手术组共有129例复发（局部区域复发36例，远处转移93例），放化疗组共有118例复发（局部区域复发79例，远处转移39例），两组复发部位的构成比差异有统计学意义（χ²=37.75，P < 0.01）。手术组和放化疗组的中位总生存时间分别为39.5月和23.5月，两者的差异具有统计学意义（P < 0.01）。
结论胸段食管鳞癌手术治疗后复发以远处转移为主，根治性放化疗后的复发则以局部区域复发为主。手术治疗的生存结果优于根治性放化疗。

Abstract:
Objective To investigate the site of recurrence and overall survival (OS) in the patients with thoracic esophageal squamous cell carcinoma treated with surgery or definitive chemoradiation therapy (CRT).
Methods We retrospectively reviewed the recurrence and survival time of the patients with primary esophageal squamous cancer. OS was calculated using the Kaplan-Meier method. Multivariate analysis to determine the independent prognostic factors was performed by the Cox regression model.
Results A total of 334 patients treated with surgery and 252 treated with definitive CRT were included in this analysis. A total of 129 (36 locoregional and 93 distant) and 118 (79 locoregional and 39 distant) patients experienced the recurrence in the surgery and CRT groups, respectively (χ²=37.75, P < 0.01). The median OS were 39.5 and 23.5 months in the surgery and CRT groups, respectively (P < 0.01).
Conclusion The sites of recurrence differ between surgery and CRT on the patients with thoracic esophageal squamous cell carcinoma. Surgery is associated with improved overall survival, compared with definitive CRT.

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