pT1~3N0M0期胸段食管鳞癌患者根治术后失败再治疗结果分析

沈文斌; 高红梅; 祝淑钗; 李腾; 李曙光; 李幼梅; 刘志坤; 李娟; 苏景伟

doi:10.3971/j.issn.1000-8578.2017.17.0178

pT1~3N0M0期胸段食管鳞癌患者根治术后失败再治疗结果分析

Salvage Therapy for Post-operative Local Recurrence or Metastasis in Stage pT1-3N0M0 of Thoracic Esophageal Squamous Cell Carcinoma

摘要

摘要:
目的分析pT1~3N0M0期胸段食管鳞癌患者根治术后失败模式，失败后挽救治疗的价值及其预后影响因素。
方法对接受根治性手术治疗，并在术后出现失败的265例pT1~3N0M0期胸段食管鳞癌患者进行回顾性分析，应用SPSS19.0软件分析其失败模式以及挽救性治疗对患者预后的价值及其影响因素。
结果失败后全组患者1、3、5年总生存率分别为42.9%、20.0%和15.2%，中位9.8月（95%CI：7.9~11.7）。单因素分析结果显示患者年龄、分化程度、失败类型、失败后放疗和放化疗为显著影响失败后患者生存的因素（χ²=5.090，8.319，11.566，17.982，6.878；P < 0.05）。多因素分析结果显示分化程度，失败后治疗和失败后放化疗为独立性预后影响因素（P < 0.05）。
结论分化程度和失败后治疗模式为影响pT1~3N0M0期胸段食管鳞癌根治术后失败的独立性因素，挽救性放疗和放化疗可以提高此部分患者的生存率。

Abstract:
Objective To analysis the failure mode and the efficacy of salvage therapy for post-operative local recurrence or metastasis in stage pT1-3N0M0 thoracic esophageal squamous cell carcinoma.
Methods A retrospective analysis was performed in 265 patients with post-operative local recurrence or metastasis in stage pT1-3N0M0 thoracic esophageal squamous cell cancer who were admitted to the Fourth Hospital of Hebei Medical University from January 2007 to December 2010. SPSS19.0 software was used to analyze the failure mode, the value of salvage therapy and its influencing factors.
Results In all patients, the 1-, 3-and 5-year overall survival rates were 42.9%, 20.0% and 15.2%, respectively; the median time was 9.8 months(95%CI:7.9-11.7) after failure. Univariate analysis showed that age, degree of differentiation, type of failure, radiotherapy and chemoradiotherapy after failure were associated with OS(χ²=5.090, 8.319, 11.566, 17.982, 6.878; P < 0.05). Multivariate analysis showed that degree of differentiation, treatment after failure, chemoradiotherapy after failure were the independent factors for OS(P < 0.05).
Conclusion The degree of tumor differentiation and the treatment mode after failure are the independent factors for stage pT1-3N0M0 thoracic esophageal squamous cell carcinoma after radical resection. Salvage radiotherapy and chemoradiotherapy can improve OS after recurrence.

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