王玉祥; 董石磊; 何明; 李静; 杨洁; 齐战; 祝淑钗; 乔学英

doi:10.3760/cma.j.issn.1004-4221.2018.02.005

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• 胸部肿瘤 •

pT1-3N0M0期食管鳞癌二野术后复发和转移的因素分析

中华放射肿瘤学杂志, 2018,27(2) : 145-149. DOI: 10.3760/cma.j.issn.1004-4221.2018.02.005

摘要

目的

回顾分析影响pT_1-3N₀M₀期食管鳞癌术后复发和转移的因素。

方法

收集胸段食管鳞癌行胸腹二野R₀术后、病理分期为pT_1-3N₀M₀期、手术前后未行辅助放疗和/或化疗、术后生存期≥3个月者488例。Cox模型多因素分析。

结果

至随访期结束总复发率为36.9%(180/488)，LRR率为21.5%(105/488)、DM率为6.8%(33/488)，LRR合并DM率为8.6%(42/488)。多因素分析显示肿瘤位置和pT分期是影响术后总复发、LRR和DM的因素；胸上段鳞癌和pT₃期者复发率高，胸中段鳞癌和pT₂期者次之，胸下段鳞癌和pT₁期者复发率低。

结论

肿瘤位置和pT分期是影响pT_1-3N₀M₀期食管鳞癌二野R₀术后复发和转移的重要因素，其结果有助于指导术后辅助放疗适应证选择。

引用本文: 王玉祥, 董石磊, 何明, 等. pT1-3N0M0期食管鳞癌二野术后复发和转移的因素分析 [J] . 中华放射肿瘤学杂志, 2018, 27(2) : 145-149. DOI: 10.3760/cma.j.issn.1004-4221.2018.02.005.

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食管鳞癌术后LRR和/或DM发生率很高，且以LRR为主^{[1,2,3,4,5,6,7]}。我们既往已报道了pT₂N_0-1M₀和pT₃N₀M₀期胸段食管鳞癌术后的复发模式及影响因素^[8,9]；本研究拟在既往研究基础上，进一步验证影响pT_1-3N₀M₀期胸段食管鳞癌单纯胸腹二野根治术后复发的因素，为临床术后辅助治疗选择提供参考。

贡献者信息

王玉祥

050011　石家庄，河北医科大学第四医院放疗科

董石磊

050011　石家庄，河北医科大学第四医院放疗科

何明

050011　石家庄，河北医科大学第四医院胸外科

李静

050011　石家庄，河北医科大学第四医院放疗科

杨洁

050011　石家庄，河北医科大学第四医院放疗科

齐战

050011　石家庄，河北医科大学第四医院胸外科

祝淑钗

050011　石家庄，河北医科大学第四医院放疗科

乔学英

050011　石家庄，河北医科大学第四医院放疗科

关键词

食管肿瘤/外科学; 食管切除术/二野; 复发;

历史

出版日期：2018-02-15

收稿日期：2017-05-24

Thoracic Tumors

Analysis of risk factors of recurrence of pT_1-3N₀M₀ esophageal squamous cell carcinoma after two-field esophagectomy

Yuxiang Wang, Shilei Dong, Ming He, Jing Li, Jie Yang, Zhan Qi, Shuchai Zhu, Xueying Qiao

Published 2018-02-15

Cite as Chin J Radiat Oncol, 2018, 27(2): 145-149. DOI: 10.3760/cma.j.issn.1004-4221.2018.02.005

Abstract

Objective

To retrospectively analyze the factors of postoperative recurrence of stage pT_1-3N₀M₀ esophageal squamous cell carcinoma.

Methods

A total of 488 patients who underwent two-field R₀ esophagectomy, pathologically classified as stage pT_1-3N₀M₀, without adjuvant radiotherapy and/or chemotherapy before or after surgery and postoperative survival time≥ 3 months were enrolled in this study. Multivariate analysis was performed by using Cox model.

Results

At the end of follow-up, the overall recurrence rate was 36.9%(180/488); the local recurrence rate was 21.5%(105/488), the distant metastasis rate was 6.8%(33/488) and the local recurrence rate complicated with the distant metastasis rate was 8.6%(42/488). Cox multivariate analysis demonstrated that tumor site and pT staging were the factors affecting the overall/local recurrence rate and distant metastasis. The recurrence rate in patients with the upper esophageal squamous cell carcinoma and stage pT₃ was the highest, followed by those with the middle esophageal squamous cell carcinoma or stage pT₂ and the lowest recurrence rate was observed in patients with the lower esophageal squamous cell carcinoma or stage pT₁.

Conclusions

Tumor site and pT staging are the pivotal factors for postoperative recurrence of stage pT_1-3N₀M₀ esophageal squamous cell carcinoma after two-field R₀ esophagectomy, which contributes to offer guidance to the selection of indications for postoperative adjuvant radiotherapy.

Key words:

Esophageal neoplasm/surgery; Esophagectomy/two-field; Recurrence

Contributor Information

Yuxiang Wang