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首页> 外文期刊>Annals of Surgery >Unique Considerations for Females Undergoing Esophagectomy
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Unique Considerations for Females Undergoing Esophagectomy

机译：对接受食管切除术的女性的独特考虑因素

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Objective: To improve understanding of sex differences in clinicopathologic characteristics, treatment and outcomes between male and female patients undergoing esophagectomy for esophageal cancer. Summary Background Data: Esophageal cancer is a male predominant disease, and sex has not been considered in previous studies as an important factor in diagnosis or management. Sex differences in demographics, clinicopathologic characteristics, and postoperative outcomes remain largely undefined. Methods: Retrospective review of 1958 patients (21% female) with esophageal cancer who underwent esophagectomy at a single institution between 1995 and 2017. Results: Most patients had adenocarcinoma (83%); however, the rate of squamous cell carcinoma was significantly higher in females (35% vs 11%, respectively;P < .0001). Females had a lower rate of smoking (62 vs 73%) and heavy alcohol use (12 vs 19%) but a higher rate of previous mediastinal radiation (8.4 vs 1.8%) (P< 0.001). Postoperative mortality and overall survival (OS) were similar between sexes. However, subanalysis of patients with locoregional disease (clinical stage II/III) demonstrated that females received neoadjuvant therapy less frequently than males and had worse OS (median OS 2.56 yrs vs 2.08;P= 0.034). This difference remained significant on adjusted analysis (HR 1.24, 95% CI 1.06-1.46). Conclusions: Female patients had higher incidence of squamous cell carcinoma despite lower prevalence of behavioral risk factors. Among patients with locoregional disease, undertreatment in females may reflect treatment bias and history of previous mediastinal radiation. Esophageal cancer in females should be considered a unique entity as compared with the presentation and treatment of males.
机译：目的：提高对食管癌食管切除术治疗食管切除术的临床病理特征，治疗和结果的性差异的理解。发明内容背景数据：食管癌是一种男性主要疾病，并且在以前的研究中未被考虑性是诊断或管理的重要因素。人口统计学，临床病理特征和术后结果的性差异很大程度上是未定义的。方法：对1958名患者（21％雌性）对1995年至2017年间单一机构进行食管切除术的食管癌回顾性审查。结果：大多数患者患有腺癌（83％）;然而，女性鳞状细胞癌的速率显着高（35％与11％; P <.0001）。雌性的吸烟率较低（62 vs 73％）和重质醇（12 vs 19％），但先前纵隔辐射的较高速率（8.4 vs 1.8％）（p <0.001）。术后死亡率和整体存活（OS）在性别之间相似。然而，患有型患者患者的患者（临床阶段II / III）的副分析表明，女性接受了比男性更频繁的Neoadjuvant疗法，并且具有更差的OS（中位数OS 2.56 YRS VS 2.08; P = 0.034）。这种差异对调整分析（HR 1.24,95％CI 1.06-1.46）保持显着。结论：虽然行为风险因素较低，但女性患者患有鳞状细胞癌的发病率较高。在患有型患者疾病的患者中，女性的疾病可能反映先前纵隔辐射的治疗偏见和历史。与男性的呈现和治疗相比，女性的食管癌应该被视为独特的实体。

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