目的:探讨70岁以上老年食管癌患者术后生存情况及其影响因素.方法:回顾性分析2000年1月至2009年12月广东省梅州市人民医院手术治疗的70岁以上食管癌患者62例的临床资料,采用单因素和多因素方法分析影响预后的各种因素.结果:全组总的5年生存率为26.2%.年龄、手术性质、浸润深度、淋巴结转移和TNM分期是影响患者预后的主要因素,其中手术性质、淋巴结转移、病理分期为独立预后因素.结论:老年食管癌患者术前应全面检查,尽量避免单纯探查手术和姑息手术.手术应强调规范化与个体化兼顾的原则,加强围术期呼吸道管理,积极防治呼吸系统并发症.%Objective To investigate the prognostic factors for patients more than 70 years of age receiving surgical resection of esophageal carcinoma. Methods Clinical data of 62 patients aged ?& 70 years who underwent esophageal carcinoma surgery from Jan 2000 to Dec 2009 were retrospectively analyzed. The prognostic factors were assessed by univariate and multivariate COX regression analysis. Results The total 5-year survival rate was 26.2% in this series. Age, operative types (radical resection or non-radical resection), invasive depth, lymph node metastasis, and TNM stage were the main factors affecting patients' prognosis. Multivariate COX analysis demonstrated that non-radical resection, advanced TNM stage, and advanced lymphatic metastasis were significant, independent, unfavorable prognostic determinants in patients. Conclusions Every effort should be made to detect earlier stage of esophageal carcinoma in patients who might benefit from surgical treatment. Try to avoid palliative operation surgical exploration. Standardized and individualized principle should be emphasized during the perioperative period. Prevention and cure of complications of respiratory system is crucial.
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