1 Department of Oncological Surgery, 2 Department of Radiation Oncology, 3 Department of Pathology, The Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, Fuzhou 350014, China.
Ann Transl Med. 2015 Nov;3(19):282. doi: 10.3978/j.issn.2305-5839.2015.11.05.
To analyze prognostic factors in patients with thoracic esophageal carcinoma staged pT1-4aN0M0 and undergone esophagectomy with 3-field lymphadenectomy and to evaluate the effect of postoperative radiotherapy.
From January 1993 to March 2007, 770 patients with stage pT1-4aN0M0 underwent 3-field lymphadenectomy at Fujian Province Cancer Hospital, China were enrolled for analysis. The study consisted of 770 patients with stage pT1-4aN0M0 who underwent 3-field lymphadenectomy at Fujian Province Cancer Hospital, China. A total of 687 had received surgery only, and 83 patients had undergone surgery followed by postoperative radiotherapy. Radiation dose was 50 Gy in 25 fractions.
The overall survival rates at 1, 3, 5, and 10 years were 92.9%, 80.8%, 71.7% and 57.4%, respectively. Univariate analysis showed that age and T staging were two independent factors on prognoses. Five-year survival in cases younger and older than 60 were 76.5% vs. 63.3% (P=0.001), while those of pT1, pT2, pT3 and pT4a were 83.8%, 78.8%, 67.8% and 54.1%, respectively (P=0.000). Five-year survival in group of simple surgery was 71.3%, compared with 74.5% in group of surgery plus postoperative radiotherapy (P=0.763), while stratified analysis indicated that postoperative radiotherapy was able to boost the survival of patients in pT4a which were 72.4% vs. 33.8% (P=0.036) and to lower relapse rate of tumor bed in patients with pT4a (P=0.005). Multivariate analysis showed that age and T staging were two independent factors on prognoses.
Patients with high T staging and at an age more than 60 turned out bad prognoses, neither could postoperative radiotherapy improve their survival.
分析胸段食管癌 pT1-4aN0M0 期患者行三野淋巴结清扫术的预后因素，并评估术后放疗的效果。
1993 年 1 月至 2007 年 3 月，中国福建省肿瘤医院共对 770 例 pT1-4aN0M0 期胸段食管癌患者行三野淋巴结清扫术，进行分析。本研究共纳入 770 例 pT1-4aN0M0 期胸段食管癌患者，其中 687 例行单纯手术，83 例行手术加术后放疗。放疗剂量为 50 Gy/25 次。
1、3、5、10 年总生存率分别为 92.9%、80.8%、71.7%和 57.4%。单因素分析显示，年龄和 T 分期是影响预后的两个独立因素。60 岁以下和 60 岁以上患者的 5 年生存率分别为 76.5%和 63.3%（P=0.001），T1、T2、T3 和 T4a 期患者的 5 年生存率分别为 83.8%、78.8%、67.8%和 54.1%（P=0.000）。单纯手术组的 5 年生存率为 71.3%，手术加术后放疗组为 74.5%（P=0.763），分层分析显示，术后放疗可提高 T4a 期患者的生存率（72.4%对 33.8%）（P=0.036），降低 T4a 期肿瘤床复发率（P=0.005）。多因素分析显示，年龄和 T 分期是影响预后的两个独立因素。
T 分期高和年龄大于 60 岁的患者预后不良，术后放疗不能改善其生存。
