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目的研究T3期食管癌根治术后患者的预后因素。方法1990年1月至1999年1月间进行根治性手术的T3期胸下段食管癌患者190例,分成实验组108和对照组82例,并分为3次以下化疗组56例和3次以上化疗组52例。实验组于术后3～4周动脉灌注顺铂加5氟脲嘧啶,每4～6周1次,所有患者全部随访,选择5个可能影响预后的因素数据经统计学处理。结果动脉灌注化疗组与对照组间的远期生存率无统计学差异;即使存在淋巴结转移,经动脉灌注化疗组与对照组间比较也不延长远期生存;而3次以上动脉灌注化疗可以延长T3期食管癌根治术后的远期生存。经过COX比例风险模型分析。年龄、性别、部位等不影响患者的预后,但淋巴结转移和3次以上动脉灌注化疗是影响食管癌切除术的主要因素。结论淋巴结转移和3次以上动脉灌注化疗是影响食管癌切除术后预后的重要因素。为提高预后,应常规进行区域淋巴结清扫,并于术后进行3次以上的辅助化疗。
Objective To study the prognostic factors of patients with stage T3 esophageal cancer after radical operation. Methods Totally 190 patients with T3 stage lower thoracic esophageal cancer undergoing radical operation from January 1990 to January 1999 were divided into experimental group 108 and control group 82 cases and divided into three times the following chemotherapy group 56 cases and more than 3 times Chemotherapy group of 52 cases. In the experimental group, cisplatin plus 5-fluorouracil was infused intraperitoneally 3 to 4 weeks after operation, and once every 4 to 6 weeks. All the patients were followed up. Five factors influencing the prognosis were selected and statistically analyzed. Results There was no significant difference in the long-term survival rate between the arterial infusion chemotherapy group and the control group. Long-term survival was not prolonged by the arterial infusion chemotherapy group and the control group, even if there was lymph node metastasis. More than 3 times of arterial infusion chemotherapy could be prolonged Long-term survival after T3 radical resection of esophageal cancer. After COX proportional hazards model analysis. Age, sex, location, etc. do not affect the prognosis of patients, but lymph node metastasis and more than three arterial infusion chemotherapy is the main factor affecting esophageal resection. Conclusion Lymph node metastasis and three times more arterial infusion chemotherapy is an important factor affecting the prognosis of esophageal cancer resection. In order to improve the prognosis, regional lymph node dissection should be routinely performed and postoperative adjuvant chemotherapy should be performed more than 3 times.