Analysis Of Prognostic Factors In Esophageal Adenocarcinoma Clinical

Objective: Esophageal adenocarcinoma is a malignant one of itstreatment of a preferred surgery or surgery combined therapy, the higher thedegree of malignancy of esophageal adenocarcinoma incidence increased yearby year in China, postoperative prognosis survival differences. We are tryingthrough retrospective analysis of prognostic factors of surgical treatment ofadenocarcinoma of the esophagus, and to discuss the clinical treatment ofesophageal adenocarcinoma, and to improve the long-term prognosis ofpatients with esophageal adenocarcinoma, improve long-term survival ofpatientsMethods: Retrospective analysis of Thoracic Surgery, Fourth Hospital ofHebei Medical University from January2003to February2008menstrualsurgical treatment of esophageal adenocarcinoma50cases, including42casesof male patients, female patients, the male to female ratio of about6.25:1andage distribution42-78years old. Lesions in the three cases, the middle of the15cases,33cases in the lower segment of the upper esophagus, underwentradical resection, including exploration1cases. Removal of the esophagus andstomach after the three cuts esophageal cancer of the abdomen and right chest,neck and neck consistent three cases, two right chest incision esophagectomytwo cases, abdominal aortic arch through left port esophageal resectionesophagogastric anastomosis in16cases28cases left chest aortic archanastomosis. The pathological examination of the specimen after surgery:clinical residual invasion two cases on the residual glandular epitheliumatypical hyperplasia on residual nerve involvement on residual vascularinvasion cases;21cases of poorly differentiated adenocarcinoma, glandularspines cell carcinoma of the three cases, mucus gland cell carcinoma,mucoepidermoid cell carcinoma; lesions invading the mucous layer two cases, invading the muscularis10cases, invading fiber membrane10cases, invadingthe surrounding tissue,28cases of lymph node dissection number0-17(including thoracotomy patients without lymph node dissection, two cases oflymph node dissection of the surrounding soft tissue or fat necrosis nodules),cleaning average approximately7.04, the average transfer1.15, the positiverate of about16.3%subcarinal lymph node metastasis in two cases, sevencases of lymph node metastasis in esophageal, left gastric lymph nodemetastasis in12cases; cardia six cases of lymph node metastasis; inferiorpulmonary ligament metastasis. Did not occur after anastomotic leak andchylothorax, wound infection in one cases, the remainder of cases weredischarged after1month follow-up no death. According to the AJCC(American Joint Committee on Cancer American Cancer Federation)20097thedition of esophageal adenocarcinoma TNM staging: Ⅰ a2Li, Ⅰ b6Li, Ⅱaperiod of one cases, Ⅱ b period of11Li, stage Ⅲ a12Li Ⅲc16cases (oneexample thoracotomy), another staging lymph node dissection for soft tissuearound not one cases. Application SPSS13.0statistical software for statisticalanalysis of this set of data, the survival rates between the various groups to theKaplan-Meier method, using the Log-Rank test was used to compare eachgroup between survival the differences and Cox multivariate regression forthis set of data analysis, P <0.05for the difference was statistically significant,life-table method to calculate survival rate.Results: Each group between survival rate calculated by theKaplan-Meier method, Log-Rank test to compare the group difference insurvival between the age, sex, tumor location, lymph node metastasis, andlymph node metastatic sites (except cardia lymph nodes).prognosis survivalrate in patients with no significant difference (P>0.05); lymph nodemetastasis in a number of tumor differentiation, tumor invasion depth andclinical TNM stage on the the prognostic survival rate of patients withesophageal adenocarcinoma difference was statistically significant byCOXmultivariate analysis found that the influencing factors are not independentrisk factors affect the survival rates of patients with esophageal adenocarcinoma, the life table method to calculate this set of data for the5-year survival rate was13%.Conclusion: Gender, age, tumor location, lymph node metastasis andlymph node metastatic sites (except cardia lymph nodes) and the5-yearsurvival rate of patients with esophageal adenocarcinoma; cardia lymph nodemetastasis, number of lymph node metastasis, tumor differentiation, tumorinvasion and depththe5-year survival and clinical TNM staging of patientswith esophageal adenocarcinoma correlation, but all relevant factors are notaffected in patients with5-year survival independent risk factor. The datashowed that esophageal adenocarcinoma in patients with lymph nodemetastasis number, the less tumor invasion and more shallow depth, the TNMstage the sooner the better long-term prognosis. The findings of esophagealadenocarcinoma in the seventh edition of TNM staging consider lymph nodemetastasis in the number of clinical staging more beneficial than ever, moreclinical significance; esophageal adenocarcinoma and esophageal squamouscell carcinoma, the same should be early detection, early diagnosis and earlytreatment You can enhance the long-term survival of patients.