Department of Thoracic Surgery, Institute of Basic Medicine and Cancer (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, 1 East Banshan Rd, Hangzhou, 310022, China.
Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Beijing, China.
Updates Surg. 2022 Aug;74(4):1187-1197. doi: 10.1007/s13304-022-01256-y. Epub 2022 Feb 25.
The impact of positive circumferential resection margin on prognosis in esophageal cancer is under controversy. Previous systematic reviews and meta-analyses had limitations. This updated systematic review and meta-analysis aimed to assess the prognostic impact of positive circumferential resection margin in esophageal cancer.PubMed and Web of Science were searched for studies investigating the association between circumferential resection margin status and prognosis in esophageal cancer. Study population were focused on T3 and/or T4a patients. Study selection was based on availability of survival information (Kaplan-Meier curves and adjusted analysis). Random-effects models were used to summarize hazard ratios for overall survival and disease-free survival.According to College of American Pathologists criteria, circumferential resection margin-positive patients had shorter median overall survival (P < 0.0001) and shorter median disease-free survival (P < 0.0001) compared with circumferential resection margin-negative patients. The pooled hazard ratios for overall survival and disease-free survival were 2.06 (95% confidence interval, 1.68-2.53; P < 0.0001) and 2.00 (95% confidence interval, 1.41-2.84; P < 0.0001), respectively. According to the Royal College of Pathologists criteria, circumferential resection margin-positive patients had shorter median overall survival (P < 0.0001) and shorter median disease-free survival (P < 0.0001) compared with circumferential resection margin-negative patients. The pooled hazard ratios for overall survival and disease-free survival were 1.31 (95% confidence interval, 1.16-1.48; P < 0.0001) and 1.31 (95% confidence interval, 1.09-1.57; P < 0.0001), respectively.ompared with negative circumferential resection margin, positive circumferential resection margin is associated with worse survival outcomes in esophageal cancer.
阳性环周切缘对食管癌预后的影响存在争议。先前的系统评价和荟萃分析存在局限性。本更新的系统评价和荟萃分析旨在评估食管癌阳性环周切缘对预后的影响。
检索 PubMed 和 Web of Science 以调查研究环周切缘状态与食管癌预后之间关系的研究。研究人群专注于 T3 和/或 T4a 患者。研究选择基于生存信息的可用性（ Kaplan-Meier 曲线和调整分析）。使用随机效应模型总结总生存率和无病生存率的风险比。
根据美国病理学家学院的标准，与环周切缘阴性患者相比，环周切缘阳性患者的中位总生存率更短（ P < 0.0001），无病生存率更短（ P < 0.0001）。总生存率和无病生存率的合并风险比分别为 2.06（95%置信区间，1.68-2.53； P < 0.0001）和 2.00（95%置信区间，1.41-2.84； P < 0.0001）。根据皇家病理学家学院的标准，与环周切缘阴性患者相比，环周切缘阳性患者的中位总生存率更短（ P < 0.0001），无病生存率更短（ P < 0.0001）。总生存率和无病生存率的合并风险比分别为 1.31（95%置信区间，1.16-1.48； P < 0.0001）和 1.31（95%置信区间，1.09-1.57； P < 0.0001）。
与阴性环周切缘相比，阳性环周切缘与食管癌的生存结局较差相关。
