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对于节点阴性食道状细胞癌的开放式和胸腔镜食道切除术之间的生存比较:一个雄心勃勃的队列研究

Xiaocan Jia¹, Tongtong Ren¹, Peinan Chen²

¹Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, High-tech Development Zone, Zhengzhou, 450001, Henan, China.

Surgical endoscopy

|October 21, 2024

概括

胸腔镜食道切除术 (TE) 显示出对节点阴性食道状细胞癌的存活率和安全性优于开放式食道切除术 (OE). TE提供了改善的整体存活率和无疾病存活率,并减少了并发症.

科学领域:

手术瘤学手术瘤学
胸部外科手术胸部外科手术
胃肠道瘤学胃肠道瘤学

背景情况:

对于食道癌 (EC) 的开放食道切除术 (OE) 和胸腔镜食道切除术 (TE) 之间的生存差异存在争议.
这项研究侧重于节点阴性食道状细胞癌 (ESCC),以比较OE与TE的生存和安全结果.

研究的目的:

在节点阴性ESCC患者中比较OE和TE之间的5年总生存期 (OS) 和无病生存期 (DFS).
在这个患者队列中评估OE和TE方法的外科安全性.

主要方法:

一项雄心勃勃的队列研究,涉及1104名节点阴性ESCC患者,接受OE或TE治疗.
主要终点包括5年的OS和DFS;次要终点是手术安全.
采用多变量考克斯回归和倾向分数匹配 (PSM) 来分析结果和控制混因素.

主要成果:

胸腔镜食道切除术 (TE) 与开放式食道切除术 (OE) 相比,显示了明显更好的5年OS (83.73%对70.05%) 和DFS (77.76%对67.15%) 和DFS (77.76%对67.15%).
TE与手术内出血减少和切割的淋巴结数量增加有关.
多变量分析证实了TE与改善的长期存活率 (OS HR:0.54,DFS HR:0.68) 的关联,PSM后也有类似的发现.

结论:

胸腔透视食道切除术 (TE) 是一个更安全,更有效的手术方法,结节阴性食道状细胞癌 (ESCC) 与开放的食道切除术 (OE) 相比.
TE提供卓越的长期生存益处,为改善患者结果提供有价值的临床指导.
需要进一步的研究来阐明TE更高的生存率背后的机制.

关键词:

没有疾病的生存率.开放式食道切除术 (open esophagectomy) 是一种切开食道切除术.总体生存率总体生存率安全的安全的安全的安全的安全.胸腔镜食道切除术 (thoracoscopic esophagectomy) 是一个切除术.

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