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117 例食管鳞癌同期多原发癌的临床分析。

Clinical analysis of 117 cases with synchronous multiple primary esophageal squamous cell carcinomas.

机构信息

Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China.

出版信息

Korean J Intern Med. 2021 Nov;36(6):1356-1364. doi: 10.3904/kjim.2017.280. Epub 2020 Apr 29.

Abstract

BACKGROUND/AIMS: We aimed to study the clinical characteristics, treatment modality, and the prognosis of synchronous multiple primary esophageal squamous cell carcinomas (SMPESCC).

METHODS

A total of 117 SMPESCC cases were evaluated retrospectively from 2010 to 2015.

RESULTS

The most common locations of SMPESCC were mid- and lower thoracic segments (n = 208, 84.9%). The 1-, 2-, and 3-year overall survival rates were 53.8%, 30.8%, and 15.4%, respectively; the median survival time (MST) was 12.5 months. With definitive radiotherapy and surgery, respectively, the MST of stage I/II patients were 34.2 and 26.7 months, of stage III patients were 8.3 and 13.2 months (p = 0.163), and of stage IV patients were and 8 and 12.6 months (p = 0.379). Clinical stage, family history of cancer, and Karnofsky performance status were independent prognostic factors for the whole cohort by Cox multivariate regression analysis (hazard ratio [HR] = 0.859, p < 0.001; HR = 0.579, p = 0.032; and HR = 0.586, p = 0.013).

CONCLUSION

Although the prognosis of SMPESCC is poor, stage I/II patients can achieve long-term survival with aggressive treatment, especially those with a Karnofsky performance score 90 or higher and who have no family history of cancer. Definitive radiotherapy could achieve a similar survival rate to definitive surgery at different clinical stages.

摘要

背景/目的:本研究旨在探讨同步性多原发食管鳞状细胞癌(SMPESCC)的临床特征、治疗方式及预后。

方法

回顾性分析 2010 年至 2015 年间共 117 例 SMPESCC 患者的临床资料。

结果

SMPESCC 最常见的部位为中下段(n = 208,84.9%)。1、2、3 年总生存率分别为 53.8%、30.8%和 15.4%,中位生存时间(MST)为 12.5 个月。行根治性放疗和根治性手术的Ⅰ/Ⅱ期、Ⅲ期和Ⅳ期患者 MST 分别为 34.2、26.7 和 8.3 个月(p = 0.163)、13.2 和 8.3 个月(p = 0.379)。Cox 多因素回归分析显示,临床分期、癌症家族史和 Karnofsky 体能状态是影响总人群预后的独立因素(风险比 [HR] = 0.859,p < 0.001;HR = 0.579,p = 0.032;HR = 0.586,p = 0.013)。

结论

SMPESCC 患者预后较差,但积极治疗可使Ⅰ/Ⅱ期患者获得长期生存,特别是 Karnofsky 体能状态评分 90 分以上、无癌症家族史的患者。不同临床分期患者行根治性放疗与根治性手术的生存获益相似。

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