【作者】 陈俊强； 柳硕岩； 郑雄伟； 朱坤寿； 李建成； 林宇； 潘建基；

【Author】 (Department of Radiation Oncolygy,Fujian Provincial Tumor Hospital,Teaching Hospital of Fujian Medical University,Fuzhou,350014,China)

【机构】 福建医科大学教学医院福建省肿瘤医院放疗科；

【摘要】 [目的]分析影响颈部淋巴结转移阳性胸段食管鳞癌术后患者的预后因素,探讨验证第7版AJCC食管癌分期。[方法]选择1993年1月至2007年3月我院胸段食管鳞癌三野淋巴结清扫根治术患者1715例,术后病理诊断证实有颈部淋巴结转移阳性患者547例,其中单纯手术296例,术后放疗251例。[结果]全组颈部淋巴结转移率为31.9%,其中胸上、中及下段的锁骨上区域淋巴结转移率分别为44.2%、31.5%和14.4%(P<0.0001)。颈部淋巴结转移全组患者的5年总生存率分别为27.7%,中位生存时间27.5个月。其中单纯手术组与术后放疗组5年总生存率分别为21.3%和34.2%,中位生存时间分别为21.9个月和35.4个月(P<0.0001)。多因素分析颈部淋巴结转移阳性胸段食管鳞癌术后患者独立的预后因素是性别、pT分期、N分期和治疗方法,与原发肿瘤部位无关。[结论]颈部淋巴结转移阳性胸段食管鳞癌术后患者的预后较好,支持第7版AJCC食管癌分期中将颈部淋巴结转移归属为区域淋巴结。更多还原

【Abstract】 [Objective]To analyze the prognostic factor of cervical lymph node metastasis(CLN) in thoracic esophageal squamous cell carcinoma(TE-SCC),and to probe and to verify the esophageal carcinoma stagings of the 7th edition of AJCC.[Methods]A total of 1 715 TE-SCC patients underwent radical esophagectomy plus three-field lymph node dissection at Fujian Provincial Tumor Hospital between January 1993 and March 2007.547 patients had pathological metastasis of SLN and 296 patients received surgery only(S group) and 251 patients received postoperative radiotherapy(S+R group).[Result]The metastatic rate of CLN was 31.9%for the entire group,44.2%,31.5%and 14.4%for the upper,middle and lower TE-SCC respectively(P<0.0001).Five years overall survival rate of the patients with metastatic CLN was 27.7%,and the overall median survival time was 27.5 months.Five years survival rates was 21.3%for S group and 34.2%for S+R group;the median survival time was 21.9 months for S group and 35.4 months for S+R group(P<0.0001).Multivariate analysis showed that independent prognostic factors included gender,pT stage,N stage and treatment methods;and it has no significance with the primary tumor site.[Conclusion]TE-SCC with CLN metastasis had better prognosis after surgery.It supports that cervical lymph node belonging to regional lymph node in the 7th edition of AJCC.更多还原