中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
4期
221-224
,共4页
解明然%梅新宇%李田%柳常青%孙效辉%张正华%马冬春
解明然%梅新宇%李田%柳常青%孫效輝%張正華%馬鼕春
해명연%매신우%리전%류상청%손효휘%장정화%마동춘
食管肿瘤%淋巴结切除术%预后
食管腫瘤%淋巴結切除術%預後
식관종류%림파결절제술%예후
Esophageal neoplasms%Lymph node excision%Prognosis
目的 探讨阴性淋巴结数目对无淋巴结转移的食管鳞癌患者预后的影响.方法 回顾性分析1998年1月至2008年12月429例施行食管癌切除+现代二野淋巴结清扫术,术后病理证实无淋巴结转移的食管鳞癌患者临床病理资料.结果 全组患者中位生存期为63.0个月,1、3、5年生存率分别为78.5％、64.0％、51.2％.肿瘤侵润深度和淋巴结清扫数目是影响患者预后的独立危险因素.相同T分期患者的生存率随淋巴结清扫数目增加而增高,差异有统计学意义(P＜0.05).清扫0 ～14枚淋巴结的T1患者比清扫更多数目的T1患者预后差,差异有统计学意义(P＜0.05).清扫0～19枚淋巴结的T2-3患者比清扫更多数目的T2-3患者预后差,差异有统计学意义(P＜0.05).结论 淋巴结清扫数目是影响无淋巴结转移食管鳞癌患者预后的独立危险因素.外科医师术中应尽量清扫足够数目的淋巴结,提高患者生存率.
目的 探討陰性淋巴結數目對無淋巴結轉移的食管鱗癌患者預後的影響.方法 迴顧性分析1998年1月至2008年12月429例施行食管癌切除+現代二野淋巴結清掃術,術後病理證實無淋巴結轉移的食管鱗癌患者臨床病理資料.結果 全組患者中位生存期為63.0箇月,1、3、5年生存率分彆為78.5％、64.0％、51.2％.腫瘤侵潤深度和淋巴結清掃數目是影響患者預後的獨立危險因素.相同T分期患者的生存率隨淋巴結清掃數目增加而增高,差異有統計學意義(P＜0.05).清掃0 ～14枚淋巴結的T1患者比清掃更多數目的T1患者預後差,差異有統計學意義(P＜0.05).清掃0～19枚淋巴結的T2-3患者比清掃更多數目的T2-3患者預後差,差異有統計學意義(P＜0.05).結論 淋巴結清掃數目是影響無淋巴結轉移食管鱗癌患者預後的獨立危險因素.外科醫師術中應儘量清掃足夠數目的淋巴結,提高患者生存率.
목적 탐토음성림파결수목대무림파결전이적식관린암환자예후적영향.방법 회고성분석1998년1월지2008년12월429례시행식관암절제+현대이야림파결청소술,술후병리증실무림파결전이적식관린암환자림상병리자료.결과 전조환자중위생존기위63.0개월,1、3、5년생존솔분별위78.5％、64.0％、51.2％.종류침윤심도화림파결청소수목시영향환자예후적독립위험인소.상동T분기환자적생존솔수림파결청소수목증가이증고,차이유통계학의의(P＜0.05).청소0 ～14매림파결적T1환자비청소경다수목적T1환자예후차,차이유통계학의의(P＜0.05).청소0～19매림파결적T2-3환자비청소경다수목적T2-3환자예후차,차이유통계학의의(P＜0.05).결론 림파결청소수목시영향무림파결전이식관린암환자예후적독립위험인소.외과의사술중응진량청소족구수목적림파결,제고환자생존솔.
Objective To investigate the correlation between the number of resected lymph nodes(LNs) and the prognosis of patients with node-negative esophageal carcinoma.Methods A retrospective review of 429 patients receiving esophagectomy with morden two-field lymphadenectomy for cancer between January 1998 and December 2008 was performed.All patients were proved without lymph node involvement histopathologically.The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed.Results The overall median survival time was 63.0 months,and the 1-,3-,and 5-year overall survival rates were 78.5％,64.0％ and 51.2％,respectively.Survival analysis confirmed that the number of negative LNs and the depth of tumor invasion were showed to be independent prognostic factors.Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs(P ＜ 0.05).The patients had better long-term survival outcomes with dissected LNs counts of more than 15 for cases with pT1 tumor(P ＜ 0.05),and more than 20 for cases with pT2-3 tumor(P ＜ 0.05).Conclusion The number of negative lymph nodes is an independent prognostic predicting factor for node-negative esophageal carcinoma.Sufficient dissection of LNs is recommended to improve the survival of patients with node-negative esophageal carcinoma.
