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Effect of steroid therapy on postoperative course and survival of patients with thoracic esophageal carcinoma

机译：激素治疗对胸段食管癌患者术后病程和生存的影响

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Perioperative steroid therapy has been shown to be safe and effective in inhibiting the production of inflammatory mediators and reducing postoperative hospital morbidity. However, there is limited information to show the effect of steroid therapy on long-term survival. In this study we evaluated the effect of perioperative steroid therapy on long-term survival of patients with thoracic esophageal cancer. Methods Between 1993 and 2000, 141 consecutive patients with primary thoracic esophageal cancer underwent radical esophagectomy. A total of 78 patients who underwent surgery between 1997 and 2000 received perioperative steroid therapy. Sixty-three patients who underwent surgery between 1993 and 1996 were analyzed as the control group. In the steroid group, 250mg methylprednisolone was administered intravenously just before surgery followed by 125mg on postoperative days 1 and 2. The postoperative course and overall cause-specific survival rates were compared between the groups. Results The postoperative hospital morbidity rate was significantly lower in the steroid group than in the control group. Although overall survival of the steroid group was better than the control group, cause-specific survival of both groups was similar. Multivariate analysis suggested that the depth of tumor and postoperative hospital morbidity were significant independent prognostic factors; however, steroid therapy was not statistically significant after adjusting for pathological variables. Conclusions Perioperative steroid therapy may improve the postoperative course but does not improve the long-term survival of patients with thoracic esophageal cancer.
机译：围手术期使用类固醇疗法已被证明可安全有效地抑制炎症介质的产生并降低术后医院的发病率。但是，仅有有限的信息显示类固醇疗法对长期生存的影响。在这项研究中，我们评估了围手术期激素治疗对胸段食管癌患者长期生存的影响。方法在1993年至2000年之间，连续141例原发性胸段食管癌患者接受了根治性食管切除术。在1997年至2000年之间，共有78例接受了手术治疗的患者接受了围手术期的类固醇治疗。将1993年至1996年接受手术的63例患者作为对照组。在类固醇组中，在手术前静脉内注射250mg甲基强的松龙，然后在术后第1和2天静脉内给予125mg。比较两组患者的术后病程和总的因因生存率。结果类固醇组术后住院发病率明显低于对照组。尽管类固醇组的总生存期优于对照组，但两组的因果生存率相似。多因素分析表明，肿瘤的深度和术后发病率是重要的独立预后因素。但是，调整病理变量后，类固醇疗法在统计学上不显着。结论围手术期激素治疗可改善胸段食管癌患者的术后病程，但不能提高其长期生存率。

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