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本文报告我科1966～1982年外科治疗的食管癌370例与贲门癌79例的结果。手术切除率分别为83.5％及54.4％。切除死亡率分别为6.1％及7.0％(近3年下降至2.3％及0)。按生命表法统计,食管癌的5、10年生存率分别为32.5％、22.1％;贲门癌的5、10年生存率均为30.7％。按国际分期,食管癌各期的5、10年生存率分别为:Ⅰ期54.3％、45.9％,Ⅱ期34.1％、21.5％,Ⅲ期29.8％,25.8％。在Ⅲ期病例中,如术前先行放射治疗,则其5、10年生存率升至60.1％、46.7％;而单一外科治疗的同期病例其5、10年生存率均只有17.2％。贲门癌Ⅱ、Ⅲ期的5、10年生存率分别均为81.8％及24.7％。病程、肿瘤跃度、肿瘤部位和术前放射等4个因素均直接影响手术切除率。性别、肿瘤长度、临床病理大体分型、区域淋巴结有否转移、临床病理分期、手术性质和术前放射等7个因素均与病人的生存率有关。
This article reports the results of 370 cases of esophageal cancer and 79 cases of cardia cancer surgically treated in our department from 1966 to 1982. The surgical resection rate was 83.5% and 54.4%, respectively. The mortality rate of excision was 6.1% and 7.0% (falling to 2.3% and 0 in the past 3 years). According to the life table method, the 5-year and 10-year survival rates of esophageal cancer were 32.5% and 22.1%, respectively. The 5-year and 10-year survival rates of cardiac cancer were all 30.7%. According to the international staging, the 5-year and 10-year survival rates of esophageal cancer were 54.3% and 45.9% in phase I, 34.1%, 21.5% in phase II, and 29.8% and 25.8% in phase III, respectively. In stage III cases, if preoperative radiotherapy was performed, the 5- and 10-year survival rates rose to 60.1% and 46.7%, respectively, while the 5-year and 10-year survival rates of single-surgery cases were only 17.2%. The 5-year and 10-year survival rates of stage II and III cardiac cancers were 81.8% and 24.7%, respectively. Four factors, such as disease course, tumor jerk, tumor location and preoperative radiation, all directly affected the surgical resection rate. Sex, tumor length, general classification of clinical pathology, regional lymph node metastasis, clinical pathological staging, nature of surgery, and preoperative radiation were all related to the patient’s survival rate.