Alidina A, Gaffar A, Hussain F, Islam M, Vaziri I, Burney I, Valimohd A, Jafri W
The Aga Khan University, Karachi, Pakistan.
Ann Oncol. 2004 Jan;15(1):118-22. doi: 10.1093/annonc/mdh014.
Esophageal cancer is common in Pakistan. An attempt has been made for the first time to look at the survival data and prognostic factors associated with esophageal cancer in this region.
We did a retrospective review of 263 cases seen at the Aga Khan University Hospital in Karachi. Data analysis was done using the Kaplan-Meier method and the Cox proportional hazard model.
Squamous cell carcinoma was noted in 81% of the cases, whereas adenocarcinoma was the second most common. At the time of diagnosis, early-stage disease was found in 25%, locally advanced in 41% and metastatic in 34% of all cases. Mean age at diagnosis was 56 years, with 59% males and 41% females. Survival data were available in 89 cases. Median survival was 7 months. On univariate analysis, the following factors were of prognostic significance: obstruction, histology, albumin level at diagnosis, age and platelet count. On multivariate analysis, three factors were found prognostic: presence or absence of obstruction, squamous cell carcinoma versus adenocarcinoma and platelet count.
We found that patients with squamous cell carcinoma and absence of thrombocytopenia and obstruction had a better overall survival. However, this is a limited retrospective analysis; we therefore recommend that these prognostic factors be evaluated in larger studies.
食管癌在巴基斯坦很常见。首次尝试研究该地区食管癌的生存数据及相关预后因素。
我们对在卡拉奇阿迦汗大学医院就诊的263例病例进行了回顾性分析。采用Kaplan-Meier法和Cox比例风险模型进行数据分析。
81%的病例为鳞状细胞癌，腺癌是第二常见类型。诊断时，25%的病例为早期疾病，41%为局部晚期，34%为转移性疾病。诊断时的平均年龄为56岁，男性占59%，女性占41%。89例有生存数据。中位生存期为7个月。单因素分析显示，以下因素具有预后意义：梗阻、组织学类型、诊断时的白蛋白水平、年龄和血小板计数。多因素分析发现，三个因素具有预后意义：有无梗阻、鳞状细胞癌与腺癌以及血小板计数。
我们发现鳞状细胞癌患者、无血小板减少和梗阻者总体生存率较好。然而，这是一项有限的回顾性分析；因此，我们建议在更大规模的研究中评估这些预后因素。
