中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

302例老年食管癌患者生存时间影响因素分析

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目的 回顾性分析探索影响老年食管癌患者生存时间的可能因素,为老年食管癌患者的防治提供临床证据。 方法 回顾性分析 2012 年 1 月至 2016 年 10 月在兰州大学第一医院、甘肃省肿瘤医院入院治疗 302 例食管癌患者的资料,并完成随访,收集患者生存时间,采用 Kaplan-Meier 法对生存时间进行估计并进行单因素分析,生存曲线用 log-Rank 进行检验,在单因素分析后对生存时间有意义的因素进行 Cox 比例风险模型的多因素分析。 结果 根据纳入排除标准,最终收集 302 例符合条件的患者,男 231 例、女 71 例,平均年龄(66.0±6.0)岁。① 单因素分析显示,患者年龄、肿瘤分期、肿瘤部位、KPS 评分,以及治疗方式均为预后相关因素(P<0.05);② Cox 比例风险多因素分析显示,患者年龄以及治疗方式是影响食管癌患者预后的独立因素(P<0.05)。③ 年龄≤70 岁的患者预后优于>70 岁的患者,单纯化疗与单纯手术生存情况远优于单纯放疗。 结论 年龄、治疗方式是老年食管癌患者生存时间的独立预后因素,老年食管癌患者的治疗依旧需要前瞻性研究予以论证。

Objective Retrospectively analyze the possible factors which influence the survival time of elderly patients with esophageal cancer, and provide clinical evidence for the prevention and treatment of elderly patients with esophageal cancer. Methods We retrospectively analyzed the data of patients with esophageal cancer in between January 2012 and October 2016 in the First Hospital of Lanzhou University, Gansu Province Tumor Hospital, completed the follow-up, collected patients survival time. Kaplan-Meier method was used to estimated and analyzed the single factor, survival curve with Log-Rank test, The Cox regression model was used for multivariate prognostic analysis. Results According to the inclusion exclusion criteria, 302 cases were eventually collected, 231 males and 71 females, with an average age of 66.0±6.0 years.The univariate e analysis showed that the age, tumor stage, tumor site, KPS score, and treatment were prognostic factors (P<0.05).Multivariate analysis showed that the patient age and treatment were independent factors for overall survival (OS) and progress-free survival(PFS) (P<0.05). The OS and PFS of patients with ≤70 years were better than those of patient more than 70 years. Chemotherapy alone and surgery alone survival situation was better than radiotherapy alone. Conclusion Age and treatment are independent prognostic factors in elderly patients with esophageal cancer survival time, the treatment of elderly patients with esophageal cancer still needs prospective studies to demonstrate.

关键词: 老年; 食管癌; 生存时间; 影响因素; 治疗

Key words: Elderly; esophageal cancer; survival time; factors; treatment

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