Ann Surg：食管或胃食管交界处腺癌患者的不同淋巴结转移位置的不同影响

2016-11-01 MedSci MedSci原创

研究对象为食管或胃食管交界处(GEJ)腺癌患者，新辅助治疗后食管切除术治疗腺癌，研究目的是确定淋巴结转移位置的预后意义。新辅助治疗后检测上纵隔及腹腔动脉的淋巴结转移，切除不改变食管肿瘤的TNM分类。这些远处的淋巴结转移对生存的影响仍不清楚。 2003年3月到2013年9月，纳入479例远端食管或GEJ腺癌患者，新辅助治疗后，进行整块2场淋巴结清扫术，根据切除标本的淋巴结阳性定位，分析生存率。253

研究对象为食管或胃食管交界处(GEJ)腺癌患者，新辅助治疗后食管切除术治疗腺癌，研究目的是确定淋巴结转移位置的预后意义。

新辅助治疗后检测上纵隔及腹腔动脉的淋巴结转移，切除不改变食管肿瘤的TNM分类。这些远处的淋巴结转移对生存的影响仍不清楚。

2003年3月到2013年9月，纳入479例远端食管或GEJ腺癌患者，新辅助治疗后，进行整块2场淋巴结清扫术，根据切除标本的淋巴结阳性定位，分析生存率。

253例患者的切除标本有淋巴结转移。这些患者中，92例患者其局部节点已经转移，114例腹腔干转移，21例胸部近端转移，26例腹腔干和局部均有转移。没有淋巴结转移的患者其中位无病生存期为170个月，局部转移者为35个月，腹腔干转移者为16个月，胸部近端转移者为15个月，腹腔干和局部均有转移者为8个月。多因素分析中，淋巴结转移的位置与生存独立相关。

淋巴结转移灶的定位是生存的独立预测因子。沿腹腔轴和/或近端区域的相对遥远的淋巴结转移对生存有负面影响。因此，未来食管和GEJ腺癌分期系统应该考虑淋巴结转移位置。

原始出处：

Anderegg MC1, Lagarde SM, Jagadesham VP, Gisbertz SS, Immanuel A, Meijer SL, Hulshof MC, Bergman JJ, van Laarhoven HW, Griffin SM, van Berge Henegouwen MI.Prognostic Significance of the Location of Lymph Node Metastases in Patients With Adenocarcinoma of the Distal Esophagus or Gastroesophageal Junction.Ann Surg. 2016 Nov;264(5):847-853.

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2017-03-27 循证小兵

#胃食管#

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2016-11-03 sodoo

#淋巴结#

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2016-11-03 snf701207

#淋巴结转移#

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2016-11-03 zhouqu_8

#食管#

61 0
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2016-11-02 乐奕11

厉害

96 0
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2016-11-01 doctorJiangchao

继续关注

67 0
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2016-11-01 doctorJiangchao

继续学习

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