Analysis Of Prognosis Factors On Patients With 0-â…¡ Stage Esophageal Squamous Cell Carcinoma Undergone Surgical Treatment

Objective: As is known ,Esophageal Cancer is one of the most common malignant tumors in China .The best therapeutic schedule is surgical treatment and multimodality therapy .Long-term survival rate is influenced by many factors .Accordingly the prognoses are different. To investigate how to improve the long-term survival rate ,to offer guidance of the clinical therapy and modify the prognoses of patients by analyzing the prognosis factors of patients with 0-ⅡStage(TNM2009) esophageal squamous cell carcinoma undergone surgical treatment.Method:The clinical data and follow-up materials of 416 patients with 0-ⅡStage esophageal squamous cell carcinoma undergone radical correction in 4th Hospital of Hebei Medical University from Jun.2003 to Oct.2004 were reviewed retrospectively .The 416 patients were grouped according to the related factors such as Sex ,Age ,size of tumor ,tumorous position ,TNM stage ,lymph node metastasis and depth of invasion as follows: Sex :male 290,female 126,the ratio of male to female was 2.3:1;Age(35-76):the median age was 58 years old ,under 50 years old were 62 cases ,from 50-59 years old were 162 cases ,60 years or older were 192 cases;Tumorous size:<3cm were 79 cases,3cm≤size<5cm were 132 cases,≥5cm were 205 cases ; Tumorous position: esophageal epimere were 58 cases, esophageal mesomere were 227 cases, esophageal hypomere were 131 cases; Esophageal cancer is classified according to the2009 American Joint Committee on Cancer tumor–node–metastasis (TNM) classification system :Stage 0-Ⅰwere 30 cases ,stageⅡwere 386 cases ;The number of lymph node metastasis(we picked 6 or more lymph nodes from every patients .The sum was 2696,in which 166 were positive .):without positive node were 325 cases ,one positive node were 36 cases ,two or more positive nodes were 55 cases ; lymph node metastasis: metastasis group were 91 cases ,without metastasis group were 325 cases ;Depth of invasion based of TNM 2009 (Tis is preinvasive carcinoma,T1means the tumor invades mucosa and submucosa , T2 means the tumor invades muscle ,T3 means the tumor invades esophageal fibrous membranes.): Tis- T1 were 28 cases, T2 were 176 cases,T3 were 212 cases.Life cycle was divided into 2 phases—3-year and 5-year survival rate according to the follow-up materials .The overall 3-,5-year survival rates were computed with Life-table method. The survival rates were calculated with Kaplan - Meier method .comparisons of the difference in survival rates between groups were assessed by Log- Rank test .The prognostic factors were analyzed by Cox proportional hazard model .Results:Life-table method analysis revealed the overall 3-,5-year survival rates were 56% and 44% respectively .there was a statistically significant benefit in the 3-,5-year survival rates for the factors—the size of tumor ,TNM stage, the number of lymph node metastasis , lymph node metastasis or not ,depth of invasion (p<0.05);age ,sex and tumorous location had little influence on the patients'Prognosis(p > 0.05) .According to multivariate Cox analysis ,the size of tumor , the number of lymph node metastasis and depth of invasion were independent prognostic factors .Conclusion :Age ,sex and tumorous location had not obvious statistically significant in the prognosis ,whereas, the size of the tumor ,TNM stage , the number of lymph node metastasis , lymph node metastasis or not ,depth of invasion were the main factors that influenced the prognosis . The size of tumor , the number of lymph node metastasis and depth of invasion were independent prognostic factors for the patients with 0-ⅡStage Esophageal Squamous Cell Carcinoma undergone Surgical Treatment. The relationship between related factors and Prognosis can be described as that the smaller of tumor,the better ; the earlyer of TNM stage , the better; the less lymph node metastasis , the better ;the more shallowly tumor invades, the better ;on the contrary,the worse.On the basis of this report early discovery ,early diagnosis and early operation can improve the survival rate of the patients with esophageal carcinoma .It makes sure that three-early were criticality raising long-term survival rate in patients with esophageal carcinoma after surgical therapy.