【摘要】 目的:探讨高龄食管癌患者外科手术治疗的临床及其预后影响因素。方法:回顾性分析行根治性食管癌切除术的161例>70岁食管癌患者的临床资料,分析高龄食管癌患者的手术特点、围手术期死亡及预后危险因素。结果:总体1、3和5年生存率分别为77.0%、49.8%和35.9%,平均生存时间为(49.148±4.088)个月,中位生存时间为(34±6.473)个月。单因素分析结果显示,肿瘤分化程度、肿瘤浸润深度、淋巴结转移与否、淋巴结转移度(淋巴结转移数占总清除淋巴结数比例)、病理分期、肺功能和淋巴结转移区域数是术后生存时间的影响因素,P<0.05。多因素分析结果显示,肿瘤浸润深度和淋巴结转移度是患者预后的重要独立危险因素,P<0.05。其中淋巴结转移度是最重要的预后影响因素,OR=4.067,P<0.001。术后并发症发生率为24.2%(39/161),围手术期死亡率为3.1%(5/161)。结论:选择性老年食管癌患者的手术治疗可获得理想的长期生存,肿瘤浸润深度和淋巴结转移度是患者预后的重要独立危险因素。更多还原

【Abstract】 OBJECTIVE: To retrospective analyze the outcome after esophagectomy for cancer of the esophagus in patients aged over 70 years.METHODS: The clinicopathologic data of 161 patients aged over 70 years with esophageal carcinoma,underwent esophagectomy were analyzed.RESULTS: The overall 1-,3-,and 5-year survival rates were 77.0%,49.8% and 35.9%,mean survival time(49.148±4.088)months,median survival time(34±6.473)months.Univariate analysis revealed that the factors affecting the prognosis including lung functions,depth of invasion,degree of tumor differentiation,lymph node metastasis,lymph nodes metastasis ratio,regions of lymph node metastases and pathologic stages(P<0.05).Multivariate analysis showed that depth of invasion,lymph node metastasis ratio were independent prognostic factors(P<0.05).The lymph node metastasis ratio was the most impartant effect factors(OR=4.067,P<0.001).The postoperation complications rate was 24.2%(36/161),and the perioperative period death rate was 3.1%(5/161).CONCLUSIONS: Preoperative assessment should be applied in the selection of the candidates for surgery.Depth of invasion,lymph node metastasis ratio are independent prognostic factors of esophageal carcinoma.Standardized esophagectomy is still the primary treatment for esophageal cancer.更多还原