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纸质出版:2014
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胸段食管鳞癌伴或不伴颈部淋巴结转移同期放化疗预后分析[J]. 中山大学学报(医学科学版), 2014,35(3).
Prognosis Analysis of Thoracic Esophageal Squamous Cell Carcinoma with/withoutCervical Lymph Node Metastasis Treated with Concurrent chemotherapy[J]. Journal of Sun Yat-sen University (Medical Sciences), 2014, 35(3).
摘 要: 【目的】 探讨颈部淋巴结的转移侧数对非手术胸段食管鳞癌预后的影响及胸段食管鳞癌放化疗预后因素。 【方法】 将395例接受同期放化疗治疗的食管鳞癌患者分为五组:A组,无区域淋巴结转移及远处转移;B组,伴有区域淋巴结转移;C组,单侧颈部淋巴结转移不伴有其他远处转移;D组,双侧颈部淋巴结转移不伴有其他远处转移;E组,其他远处转移。研究终点是总生存率及无进展生存率,并对预后因素进行单因素和多因素分析。【结果】A、B、C、D、E组的3年OS分别为 47.6%、46.4%、33.5%、14.8%、5.7%(P = 0.000);3年无进展生存率分别为45.2%、39.5%、26.4%、4.9%、4.3%(P= 0.000)。单因素分析显示性别、肿瘤长度、T分期、M分期、化疗方案及疾病分组对总生存率及无进展生存率有影响。多因素分析显示T分期、化疗方案及疾病分组为总生存率和无进展生存率的独立预后因素。【结论】 对于胸上段和胸中段食管癌,与双侧颈部淋巴结转移相比,胸段食管鳞癌伴单侧颈部淋巴结转移预后更好,可考虑视为区域性病变。性别、T分期、同期化疗方案及颈部淋巴结转移侧数是胸段食管鳞癌的独立预后因素。
Abstract: 【Objective】 To assume that the laterality of cervical lymph nodalmetastases (CLNM) has an influence on prognosis for inoperable thoracic esophagealsquamous cell carcinoma. 【Methods】 A total of 395 inoperable esophageal SCC patientsreceiving chemoradiotherapy were classified into five groups according to differentdisease stadium of metastasis: Group A, no evidence of regional lymph nodal disease;Group B, evidence of regional lymph nodal disease; Group C, evidence of unilateralcervical lymph node metastases (CLNM); Group D, evidence of bilateral CLNM; GroupE, evidence of other metastatic diseases. The endpoints were overall survival (OS),progression-free survival (PFS). The prognostic factorswere examined in the univariate and multivariate analysis. 【Results】 Three yearOS of Group A, B, C, D, E were 47.6%, 46.4%, 33.5%; 14.8%, 5.7% (P= 0.000). On univariateanalysis, sex, tumor location, length, T stage, M stage, chemotherapy regimen anddisease stage were significantly associated with OS (P < 0.05). Multivariate analysisdemonstrated that sex, T stage, chemotherapy regimen and disease stage were prognosticfactors on OS. 【Conclusion】 Compared to bilateral CLNM, unilateral CLNM is associatedwith longer OS in esophageal SCC and should be regarded as regional disease, especially,in SCCs of the upper and middle thirds of the esophagus. Female sex, earlier T stage,cisplatin plus docetaxel as part of concurrent chemoradiotherapy and unilateralcervical nodal lymph metastasis are independent predictors of survival in esophagealSCC.
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