Welvaart K, Caspers R J, Verkes R J, Hermans J
Department of Surgical Oncology, University of Leiden, The Netherlands.
J Surg Oncol. 1991 Aug;47(4):225-9. doi: 10.1002/jso.2930470405.
The choice of treatment for patients with cancer of the esophagus and cardia is controversial. Since overall survival is poor, the most important aim of treatment should be improvement of the main complaint: the inability to eat. In a retrospective analysis of 265 patients, referred to the University Hospital in Leiden, The Netherlands, comparisons were made between palliative effects of surgical resection (N = 92) and irradiation (N = 128). Several methods of comparing surgery with irradiation are possible: (1) all surgical patients vs. all irradiated patients; (2) only those surgical patients who survived the operation (N = 70) vs. all irradiated patients (N = 128); and (3) survivors after resection (N = 70) vs. only those irradiated patients treated with "curative" radiation (N = 62). Analysis of prognostic factors showed that in both surgical and irradiated patients, the only statistically significant factor was the (dis)ability to eat. Criteria to be considered to make individual recommendations for either treatment are presented.
食管癌和贲门癌患者的治疗选择存在争议。由于总体生存率较低，治疗的最重要目标应是改善主要症状：无法进食。在对转诊至荷兰莱顿大学医院的265例患者进行的回顾性分析中，对手术切除（N = 92）和放疗（N = 128）的姑息效果进行了比较。比较手术和放疗有几种方法：（1）所有手术患者与所有接受放疗的患者；（2）仅那些手术存活的患者（N = 70）与所有接受放疗的患者（N = 128）；以及（3）切除术后的幸存者（N = 70）与仅那些接受“根治性”放疗的患者（N = 62）。预后因素分析表明，在手术和放疗患者中，唯一具有统计学意义的因素是进食（不）能力。文中提出了为每种治疗做出个体化建议时应考虑的标准。
