| BackgroundEsophageal cancer is one of the most common cancers worldwide.In China, especially in the northern region,its incidence is the highest.The incidence of Esophageal cancer in young people is less than that in the elder.However,in the recent years,the incidence of the youth is increasing.In high incidence region of esophageal cancer,the epidemiological studies showed that its population age of the onset was 10 years earlier than before.ObjectiveBy comparing the clinically pathological characteristics,therapeutic effect and prognosis factors in young and elder patients of esophageal cancer,to find the independent risk factors,which can be used as the theoretical evidence for the prevention and treatment of young people for esophageal cancer.Material and Methods1260 cases of esophageal cancer were selected in the local hospital,who were treated by surgery and pathological diagnosis from June 1,1998 to June 1,2008.In these patients,85 were aged under 40 and 472 were aged over 60.The parameters included genders,disease duration,symptoms,tumor locations,clinical stages,tumor histological types,preoperative complications,postoperative complications,treatment conditions and survival duration. The data were analyzed using SPSS15.0 software:(1) The data between two groups were analyzed with chi square test.(2) The survival curves were drawn in each group with the Kaplan-Meier method, and the survival rate variabilities were compared with Log-rank test.(3) By using Cox model,the multivariate analysis to find the independent factors which might impact the prognosis among patients of different age for esophageal Cancer.Results(1) The processing dysphagia was the main clinical manifestation of the patients with esophageal cancer;The second clinical manifestation in the young group was swallowing discomfortly and foreign body sensation after eating;While the second clinical manifestation in the elder group was chest pain after eating and weight loss.(2) Preoperative complications and postoperative complication:The rate of the young group with preoperative complications and postoperative complication was significantly lower than that of the elder group,and the difference was statistically significant.(3) The relationship between age and TNM clinical stages for esophageal cancer: Stageâ…¡,â…¢was both common in the two groups,and the incidence of stageâ…¢in the young group was higher than that of the elder group,and the difference was statistically significant.The incidence of stageâ…¢in the elder group was higher than that of the young group,and the difference was statistically significant.(4) The relationship between age and the histological types of esophageal cancer: Two common histological types were undifferentiated carcinoma and adenocarcinoma, and the incidence of undifferentiated carcinoma(50.6%) in the young group was higher than that in the elder group(44.5%),while the incidence of squamous cell carcinoma(11.7%) in the elder group was higher than that in the young group(2.4%), and the differences were statistically significant.(5) Comparison in the treatment:the rate of radical resection(60.0%) in the elderly group was higher than that in the young group(46.2%),and the differences were statistically significant. (6) The survival rate of esophageal cancer in the elderly group was higher than that of the young group,the value of x~2 was 3.56,P value was 0.04,the difference was statistically significant.(7) The median survival time of the middle piece of esophageal cancer, esophageal undifferentiated carcinoma and the clinical stageâ…£in the elder group was more than that of the young group,and the difference was statistically significant.(8) By the Cox model,age,the histological types of esophageal cancer,and clinical stages affected the prognosis significantly.ConclusionsEsophageal cancer in the young people is different from that in the elder in the aspects of preoperative complications,postoperative complications,tumor clinical stage and histological type,tumor radical resection rate,survival rate and prognosis. Cox model analysis shows that age,histological type of esophageal cancer and clinical stage are the independent risk factors which impacted the prognosis.The overall median survival time in the young group is less than that of the elder group (22 months;35 months).The incidence of adenocarcinoma and undifferentiated carcinoma in the young group is high,and malignant degree is high,and it transfered early,developed quickly,and the clinical stage is late.Moreover,the incidence of stageâ…¢in the youth group is high,and the rate of radical surgical resection is low,which are the main reasons for poor prognosis of esophageal cancer among young people.The early diagnosis,timely treatment,to seek early radical surgical treatment can significantly improve the curative effect. |
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