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目的:分析青年人食管癌的临床特征及其手术治疗效果,并与中老年人食管癌进行对比。方法:以同期手术治疗随访完整的中老年食管癌患者1936例(≥40岁)为对照,对手术治疗的青年人食管癌患者78例(<40岁)临床资料进行回顾分析。结果:<40岁青年人食管癌共78例,占同期食管癌总数的2.14%,接受手术治疗的48例(61.5%),手术切除率为81.5%,低于其他年龄组的90.1%。青年人食管癌淋巴结转移率为52.1%,高于中老年组的39.0%;手术后并发症发生率和死亡率分别为2.1%和0,均低于中老年组的9.6%和3.3%;术后1、3和5年生存率分别为74.4%、38.5%和30.8%,中老年组分别为68.4%、32.8%和23.8%,两者差异无统计学意义,P>0.05。结论:青年人食管癌好发于有重度吸烟史的男性,与中老年组食管癌比较,肿瘤分期较晚,淋巴结转移率高,手术切除率低,但其预后并不比中老年组差,手术及辅助治疗是首选治疗手段。
OBJECTIVE: To analyze the clinical features and surgical treatment of esophageal cancer in young people and to compare with esophageal cancer in middle-aged and elderly people. Methods: A total of 1936 elderly patients with esophageal cancer (≥40 years old) were enrolled in this study. The clinical data of 78 patients (<40 years old) with surgical treatment of young esophageal cancer were analyzed retrospectively. Results: Totally 78 esophageal cancer patients aged <40 years, accounting for 2.14% of the total esophageal cancer in the same period, 48 cases (61.5%) undergoing surgery, the surgical resection rate was 81.5%, which was lower than 90.1% of the other age groups. The rate of lymph node metastasis in esophageal cancer was 52.1% in young patients, which was higher than that in middle-aged patients (39.0%). The incidence of postoperative complications and mortality were 2.1% and 0%, respectively, which were lower than 9.6% and 3.3% The 1, 3, and 5-year survival rates were 74.4%, 38.5% and 30.8% respectively, while those in the middle-aged and elderly groups were 68.4%, 32.8% and 23.8% respectively. There was no significant difference between the two groups (P> 0.05). Conclusion: Esophageal cancer in young people occurs frequently in men who have a history of heavy smoking. Compared with esophageal cancer in middle-aged and elderly patients, the tumor stage is late, the rate of lymph node metastasis is high, and the rate of resection is low. However, the prognosis is not worse than that of middle- And adjuvant therapy is the preferred treatment.