A retrospective study of the effect of postoperative adjuvant therapy on patients with locally advanced pT3N0M0 esophageal squamous cell carcinoma
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摘要:
目的 探讨术后辅助治疗对于pT3N0M0食管鳞癌患者远期生存的影响。 方法 回顾性分析兰州大学第二医院2010年1月至2014年4月收治的食管鳞癌患者资料，并分为4组：单纯手术组，手术+放疗组，手术+化疗组，手术+放化疗组。收集患者的临床病理资料及远期随访结果。 结果 2010年1月至2014年4月共纳入177例患者，中位年龄61（43~78）岁。其中单纯手术组79例，术后辅助治疗组98例，其中手术+放疗组28例，手术+化疗组38例，手术+放化疗组32例。术后辅助治疗的总生存率和无瘤生存率均高于单纯手术组（P=0.012，P=0.007）。组间比较结果显示：手术+放疗组总生存率和无瘤生存率高于单纯手术组（P=0.038，P=0.011），手术+放化疗组仅总生存率高于单纯手术组（P=0.031）。 结论 pT3N0M0食管鳞癌患者可以从术后辅助放疗和放化疗中获益，尤其放疗可以达到局部区域控制的显著效果。 Abstract:Objective To evaluate the effect of postoperative adjuvant therapy on patients with locally advanced pathologic T3N0M0 (pT3N0M0) esophageal squamous cell carcinoma (ESCC). Methods In this retrospective study, we evaluated patients who underwent esophagectomy at Lanzhou University Second Hospital. Patients were divided into 4 groups: surgery-alone (S), surgery + radiotherapy group (S+RT), surgery + chemotherapy (S+CT), and surgery + chemoradiotherapy (S+CRT) groups. Both the clinicopathologic information and the long-term follow-up results were analyzed. Results From January 2010 to April 2014, a total of 177 patients with a median age of 61 years (range 43-78), were enrolled into the study. Among them, 79 received surgery alone; the remaining 98 patients received adjuvant therapy, of whom 28 patients received adjuvant radiotherapy, 38 received adjuvant chemotherapy, and 32 received adjuvant chemoradiotherapy. Overall survival and disease-free survival were better in Group S+Adjuvant than in Group S (P=0.012, P= 0.007, respectively). Comparisons among the four groups showed that the overall survival was higher in Group S+CRT than in Group S (P=0.031). Group S+RT was associated with better overall survival and disease-free survival than Group S (P=0.038, P=0.011, respectively). Conclusions Patients with pT3N0M0 ESCC could benefit from adjuvant radiotherapy and chemoradiotherapy, as radiotherapy could help achieve better locoregional control. -
表 1 四组患者的基本临床资料 例
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