病理T1N0食管鳞状细胞癌的复发和预后预测因子仅接受手术治疗
Recurrence and prognostic predictors in pathologic T1N0 esophageal squamous cell carcinoma treated with surgery alone
影响因子:2.70000
分区:医学2区 / 外科2区
发表日期:2025 Feb
作者:
Manato Ohsawa, Yoichi Hamai, Manabu Emi, Yuta Ibuki, Tomoaki Kurokawa, Ryosuke Hirohata, Nao Kitasaki, Morihito Okada
摘要
诊断为病理T1N0食管鳞状细胞癌并单独接受手术治疗的患者的预后良好，并且通常在没有辅助治疗的情况下进行跟踪。但是，在该患者组中已经观察到复发。因此，这项研究旨在鉴定病理T1N0食管鳞状细胞癌患者的复发性和预后因素，他们仅接受手术治疗。对2003年8月至2018年8月在2018年8月在2018年8月的Hiroshima University Hospital的532例接受R0切除术的患者，只有在2003年至2018年11月的cer虫中，并有cy虫氏症状氏症状，并进行了cy症。被包括在研究中。分析了复发性和预后因素，并评估了复发的细节。无复发的生存率和5年的总生存率分别为84.7％和87.2％。在12名（9.7％）患者中观察到复发。单变量和多变量分析表明，对于无复发生存率而言，组织学类型（与其他分析相比差异很差）和淋巴和/或血管侵袭（与阴性相比）具有统计学意义。 Kaplan-Meier曲线用于无复发的生存和整体生存率，表明预后根据这些因素进行了显着分层。所有分化差和阳性淋巴和/或血管侵袭的患者均经历了复发和复发模式。在病理学T1N0食管鳞状细胞瘤中，在病理学T1N0食管中，较重要的分化和淋巴和/或血管侵袭都是重要的复发和预后预测因素。具有这些预后因素的患者经常发生转移的复发率提高。因此，辅助治疗可能对此类患者有益，并且应近距离进行随访。
Abstract
Patients diagnosed with pathologic T1N0 esophageal squamous cell carcinoma and treated with surgery alone have a good prognosis and are generally followed up without adjuvant therapy. However, recurrence has been observed in this patient group. Therefore, this study aimed to identify recurrence and prognostic factors in patients with pathologic T1N0 esophageal squamous cell carcinoma who were treated with surgery alone.Of the 532 patients who underwent esophagectomy with R0 resection at Hiroshima University Hospital between August 2003 and November 2018, 124 who underwent only esophagectomy and had pathological T1N0 esophageal squamous cell carcinoma were included in the study. Recurrence and prognostic factors were analyzed and details of recurrence were evaluated.The 5-year recurrence-free survival and 5-year overall survival rates were 84.7% and 87.2%, respectively. Recurrence was observed in 12 (9.7%) patients. Univariate and multivariate analyses showed that the histologic type (poorly differentiated compared with others) and lymphatic and/or vascular invasion (positive compared with negative) were statistically significant for recurrence-free survival. Kaplan-Meier curves for recurrence-free survival and overall survival showed that prognosis was significantly stratified according to these factors. All patients with poorly differentiated and positive lymphatic and/or vascular invasion experienced recurrence and recurrence pattern is all distant metastases.Poorly differentiated and lymphatic and/or vascular invasion are important recurrence and prognostic predictors in pathologic T1N0 esophageal squamous cell carcinoma treated with surgery alone. Patients with these prognostic factors experienced increased recurrence rates, often with distant metastasis. Therefore, adjuvant therapy may be beneficial for such patients and follow-ups should be performed at closer intervals.