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新辅助治疗后食管癌术后肺部并发症和吻合口瘘的预后意义

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目的 本研究旨在确定新辅助治疗后食管癌术后肺部并发症(postoperative pulmonary complication,PPC)和吻合口瘘(anastomotic leakage,AL)对长期生存率的影响.方法 研究我院2011年至2021年期间接受新辅助治疗后根治性切除的441例食管癌患者的临床病理特征和预后,重点关注PPC和AL.采用log-rank检验和单因素、多因素Cox回归分析对患者生存率进行分析.结果 在接受新辅助治疗的食管癌患者中,PPC和AL的发生率分别为23.8%(n=105)和5.2%(n=23).单因素Cox回归分析显示,PPC与较短的无病生存期相关,而AL与较短的总生存期相关.单因素Cox回归分析显示,新辅助治疗后的PPC是无病生存期的独立不良预后因素.结论 PPC和AL分别与无病生存期和总生存期显著负相关.PPC是新辅助治疗后食管癌无病生存期的独立不良预后因素.
Prognostic significance of postoperative pulmonary complication and anastomotic leakage after neoadjuvant therapy for esophageal cancer
Postoperative pulmonary complications and anastomotic leakage are unfavorable prognostic factors in patients with esophageal carcinoma.However,the prognostic importance of pulmonary complications and anastomotic leakage after neoadjuvant treatment in these patients remains unclear.This study aimed to determine the effect of postoperative pulmonary complications and anastomotic leakage on long-term survival after neoadjuvant therapy for esophageal cancer.Our study were recruited 441 consecutive patients who had curative resection following neoadjuvant treatment for esophageal cancer in our institution from 2011-2021.The clinicopathological characteristics and prognosis of these patients were studied in terms of postoperative pulmonary complications and anastomotic leaking.Survival was analyzed using the log-rank test and multivariable Cox regression analysis.Postoperative pulmonary complications and anastomotic leakage were present in 23.8%(n=105)and 5.2%(n=23)of esophageal cancer after neoadjuvant therapy,respectively.In the univariate analyses,pulmonary complications were associated with shorter disease-free survival,while anastomotic leakage was associated with shorter overall survival.Multivariable analysis revealed that pulmonary complications after neoadjuvant therapy were independent adverse prognostic factors for disease-free survival.Taken together,postoperative pulmonary complications and anastomotic leakage ware significantly negatively correlated with disease-free and overall survival,respectively.And the postoperative pulmonary complication is an independent poor prognostic factor of disease-free survival for esophageal cancer following neoadjuvant treatment.

Esophageal cancerNeoadjuvant therapyPulmonary complicationsAnastomotic leakagePrognosis

魏政道、周建丰、杨玉赏、张含露、郑轶峰、廖世均、陈龙奇

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610041 成都,四川大学华西医院胸外科

610000 成都,西部战区总医院胸外科

食管癌 新辅助治疗 肺部并发症 吻合口瘘 预后

2024

免疫学杂志
第三军医大学,中国免疫学会

免疫学杂志

CSTPCD
影响因子:0.704
ISSN:1000-8861
年,卷(期):2024.40(3)