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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(χ~2=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。
Objective To analyze the failure modes of patients with pT1 ~ 3N0M0 stage thoracic esophageal squamous cell carcinoma after salvage and the value of salvage therapy and the prognostic factors after failure. Methods A retrospective analysis of 265 patients with pT1 ~ 3N0M0 thoracic esophageal squamous cell carcinoma who underwent radical surgery and who had failed after operation was performed. SPSS19.0 software was used to analyze the failure mode and the value of salvage therapy in patients with prognosis And its influencing factors. The overall 1, 3, 5-year overall survival rates were 42.9%, 20.0% and 15.2%, respectively, and the median survival time was 9.8 months (95% CI: 7.9 to 11.7) after the failure. Univariate analysis showed that patients’ age, differentiation degree, type of failure, radiotherapy and radiotherapy and chemotherapy after failure were the factors influencing survival after failure (χ ~ 2 = 5.090,8.319,11.566,17.982,6.878; P <0.05). Multivariate analysis showed that the degree of differentiation, the failure to post-treatment and failure of radiotherapy and chemotherapy for independent prognostic factors (P <0.05). Conclusion The degree of differentiation and the failure mode of treatment are the independent factors that affect the failure of pT1 ~ 3N0M0 thoracic esophageal squamous cell carcinoma after radical operation. Salvage radiotherapy and radiotherapy and chemotherapy can improve the survival rate of this part of patients.