Matsuda Satoru, Niihara Masahiro, Tsubosa Yasuhiro, Sato Hiroshi, Takebayashi Katsushi, Kawamorita Keisuke, Mori Keita, Tsushima Takahiro, Yasui Hirofumi, Takeuchi Hiroya, Kitagawa Yuko
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Shunto-gun, Nagaizumi-Cho, Shizuoka, 411-8777, Japan.
Department of Surgery, Division of Upper Gastrointestinal Tract, International Medical Center, Saitama University, 1397-1, Yamane, Hidaka-Shi, Saitama, 350-1298, Japan.
Surg Today. 2016 Oct;46(10):1138-45. doi: 10.1007/s00595-015-1300-6. Epub 2016 Jan 27.
We evaluated postoperative recovery after transthoracic esophagectomy using postoperative serum albumin (Alb) levels and investigated the correlation between postoperative Alb recovery and the survival of patients with esophageal cancer.
Esophageal cancer patients who underwent transthoracic esophagectomy were retrospectively reviewed. To evaluate postoperative Alb recovery, the recovery rate of Alb was used. We investigated the correlation between Alb recovery, clinicopathological factors, and the survival. Furthermore, the postoperative systemic inflammatory response was evaluated using serum C-reactive levels, and its impact on the Alb recovery was examined.
Ninety-seven (51 %) of 191 patients were classified as having insufficient Alb recovery. In the multivariate survival analysis, pStage and insufficient Alb recovery (hazard ratio 1.863; P = 0.021) were significantly independent predictive factors for the overall survival. Patients with pStage IB-IV with insufficient Alb recovery had a significantly shorter recurrence-free survival (5-year recurrence-free survival rate, 59.5 vs. 41.5 %; P = 0.035) and significantly higher serum CRP levels at POM 3 compared with patients with sufficient Alb recovery.
Insufficient Alb recovery correlates with the systemic postoperative inflammatory response and a poor prognosis. Further studies are warranted to investigate the survival benefit of intervention to enhance postoperative Alb recovery.
我们使用术后血清白蛋白（Alb）水平评估经胸段食管癌切除术后的恢复情况，并研究术后Alb恢复与食管癌患者生存率之间的相关性。
对接受经胸段食管癌切除术的食管癌患者进行回顾性分析。为评估术后Alb的恢复情况，采用Alb恢复率。我们研究了Alb恢复、临床病理因素与生存率之间的相关性。此外，使用血清C反应蛋白水平评估术后全身炎症反应，并检查其对Alb恢复的影响。
191例患者中有97例（51%）被归类为Alb恢复不足。在多因素生存分析中，p分期和Alb恢复不足（风险比1.863；P = 0.021）是总生存的显著独立预测因素。与Alb恢复充足的患者相比，p分期为IB-IV期且Alb恢复不足的患者无复发生存期显著缩短（5年无复发生存率分别为59.5%和41.5%；P = 0.035），术后第3个月时血清CRP水平显著升高。
Alb恢复不足与术后全身炎症反应及不良预后相关。有必要进一步研究提高术后Alb恢复的干预措施对生存的益处。
