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目的探讨食管癌和贲门癌患者外科治疗及预后。方法对519例食管癌和贲门癌患者的临床资料进行回顾性分析。519例中手术切除450例,胃食管弓上吻合33例,胃食管弓下吻合115例,食管三切口颈部吻合302例,分析不同手术方式组织学类型,浸润深度及有无淋巴结转移,患者术后5年生存率。结果术后并发癌44例,全组患者5年生存率为28.4%,其中食管弓上吻合,食管胃弓下吻合,食管三切口颈部吻合5年生存率分别为25.0%,23.5%和27.3%,腺癌、鳞癌、小细胞未分化癌、其它癌分别为31.3%,34.9%,12.5%和0,单因素分析显示,食管贲门癌不同手术方式组织学类型,浸润深度及淋巴结转移与预后相关,多因素分析未发现影响预后的独立因素。结论食管癌和贲门癌患者的预后与肿瘤分期、浸润深度及淋巴结转移有关,早发现和早治疗是提高患者术后生存率的关键。
Objective To investigate the surgical treatment and prognosis of patients with esophageal and cardiac cancer. Methods The clinical data of 519 patients with esophageal and cardiac cancer were analyzed retrospectively. The surgical resection in 450 cases, 33 cases of gastroesophageal bowel anastomosis, 115 cases under gastroesophageal bowel anastomosis, esophageal incision and neck anastomosis in 302 cases, analysis of different surgical histological types, depth of invasion and lymph node metastasis, patients Postoperative 5-year survival rate. Results Forty-four patients were complicated with cancer and the 5-year survival rate was 28.4%. The 5-year survival rates of anastomosis of the esophagus, anastomosis of esophageal and gastric anastomosis were 25.0%, 23.5% and 27.3% respectively %, Adenocarcinoma, squamous cell carcinoma, small cell undifferentiated carcinoma and other cancers were 31.3%, 34.9%, 12.5% and 0 respectively. Univariate analysis showed that histological types, depth of invasion and lymph node metastasis Prognosis, multivariate analysis found no independent prognostic factors. Conclusion The prognosis of patients with esophageal and cardiac cancer is related to tumor stage, depth of invasion and lymph node metastasis. Early detection and early treatment are the keys to improve postoperative survival rate.