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胃食管结合部腺癌患者的短期术后并发症和预后因素。

Short-term postoperative complications and prognostic factors in patients with adenocarcinoma of the esophagogastric junction.

机构信息

Department of Oncology Surgery, The First Affiliated Hospital of BengBu Medical College, BengBu, China.

出版信息

Thorac Cancer. 2018 Aug;9(8):1018-1025. doi: 10.1111/1759-7714.12780. Epub 2018 Jun 21.

Abstract

BACKGROUND

The study was conducted to investigate the short-term complications and prognostic factors in patients with esophagogastric junction adenocarcinoma (EGJA).

METHODS

This retrospective study included 110 EGJA patients who underwent surgery from January 2010 to November 2012 at The First Affiliated Hospital of BengBu Medical College. The overall survival and short-term complications were analyzed according to the patients' clinical characteristics.

RESULTS

The incidence of postoperative cardiopulmonary complications was significantly higher in patients with preoperative cardiopulmonary disease or elderly patients (P < 0.05). Four cases of upper margin cancer residue were detected using the abdominal approach and three using the thoracic approach, which indicated that the cancer residue margin was related to surgical approach. The overall five-year survival rate was 34.3% and statistically differed according to pathological stage and en block resection (P < 0.05). Cox regression analysis showed that lymph node metastasis (P < 0.05) and the extent of tumor invasion (P < 0.05) were independent prognostic factors.

CONCLUSION

Elderly patients with preoperative cardiopulmonary disease had an increased risk of developing postoperative cardiopulmonary complications. Lymph node status and depth of tumor invasion were independent factors related to patient prognosis.

摘要

背景

本研究旨在探讨胃食管结合部腺癌(EGJA)患者的短期并发症和预后因素。

方法

本回顾性研究纳入了 2010 年 1 月至 2012 年 11 月在蚌埠医学院第一附属医院接受手术治疗的 110 例 EGJA 患者。根据患者的临床特征,分析其总体生存率和短期并发症。

结果

术前心肺疾病或老年患者术后心肺并发症发生率明显升高(P<0.05)。经腹入路发现 4 例上切缘癌残留,经胸入路发现 3 例,表明切缘癌残留与手术入路有关。整体 5 年生存率为 34.3%,与病理分期和整块切除显著相关(P<0.05)。Cox 回归分析显示,淋巴结转移(P<0.05)和肿瘤侵犯程度(P<0.05)是独立的预后因素。

结论

术前心肺疾病的老年患者术后发生心肺并发症的风险增加。淋巴结状态和肿瘤侵犯深度是与患者预后相关的独立因素。

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