影响胃食管结合部腺癌术后患者预后的因素：一项单中心回顾性研究

Factors Influencing Postoperative Prognosis of Patients with Adenocarcinoma of Esophagogastric Junction: A Single-Center Retrospective Study

摘要: 目的：本研究旨在探究影响根治性手术治疗后的胃食管结合部腺癌患者的预后因素。方法：通过电话和门诊随访患者，以患者的一般临床资料为变量进行Kaplan-Meier单因素生存分析。将单因素生存分析具有统计学意义的因素纳入Cox比例风险模型进行多因素生存分析，并绘制生存曲线。结果：Kaplan-Meier分析结果显示术前新辅助放化疗、病理分化程度、pT分期和pN分期对预后有影响(P < 0.05)，组间3年累积生存率具有显著差异。Cox多因素生存分析结果显示，病理分化程度(HR: 4.588/2.263~9.302)、T分期(HR: 2.816/1.700~4.666)和N分期(HR: 4.425/2.276~8.606)是影响AEG患者预后的独立危险因素(P < 0.05)。结论：对于病理分化差、高T分期和高N分期的AEG患者，外科医生应认真制定个体化的综合治疗方案，对提高AEG患者的预后和生存率具有重要意义。

Abstract: Objective: To explore the prognostic factors of patients with adenocarcinoma of esophagogastric junction who underwent radical surgery. Methods: We followed up patients by telephone and outpatient clinics, and performed Kaplan-Meier survival analysis using the general clinical data of the patients as variables. The single factor with statistical significance in prognosis was included in the Cox proportional hazards model for multivariate analysis, and drew the survival curve. Results: The results of Kaplan-Meier analysis showed that preoperative neoadjuvant chemoradiation, degree of pathological differentiation, pT staging and pN staging have an impact on the prognosis (P < 0.05), and the three-year cumulative survival rate between the groups is significantly different. Cox multivariate survival analysis results show that degree of pathological differentiation (HR: 4.588/2.263~9.302), T staging (HR: 2.816/1.700~4.666) and N staging (HR: 4.425/2.276~8.606) are independent risk factors that affect the prognosis of patients with adenocarcinoma of esophagogastric junction (P < 0.05). Conclusion: For poorly differentiated, high T stage and high N stage adenocarcinoma of esophagogastric junction patients, surgeons should carefully formulate individualized comprehensive treatment plans for them, which is of great significance to improve the prognosis and survival rate of adenocarcinoma of esophagogastric junction patients.