Long-term efficacy of transhiatal esophagectomy for esophageal carcinoma and esophagogastric junction cancer

目的 评价经膈肌裂孔食管切除术(THE)治疗食管癌及食管胃交界癌的远期疗效.方法 北京大学肿瘤医院单一手术组于2000年3月至2009年12月间共计手术治疗食管癌和食管胃交界癌患者544例,其中实施THE 者63例(THE组),经胸或经腹手术者481例(非THE组),比较分析两组患者的远期生存.结果 THE组58例、非THE组427例患者的临床资料能用于生存分析.THE组1、3、5、8年累计生存率分别为91.0%、60.5%、44.6%和44.6%;非THE组则分别为84.5%、49.2%、37.2%和28.7%,差异无统计学意义(P＝0.67).结论 THE可作为治疗特定食管癌及食管胃交界癌除经胸途径以外的另一重要可选方法,其疗效不逊于传统的经胸食管切除术.Objective To evaluate the long-term efficacy of transhiatal esophagectomy (THE) for esophageal carcinoma or esophagogastric junction cancer. Methods Between March 2000 and December 2009, a total of 544 patients with either esophageal carcinoma or esophagogastric junction cancer underwent esophagectomy via THE(n＝63) or other approaches(n＝481) in Beijing cancer hospital institution. Procedures were performed by a single surgeon team. Long-term survival was compared between two groups. Results The 1-year, 3-year, 5-year, and 8-year accumulative survival rates in THE group were 91.0%, 60.5%, 44.6%, and 44.6%, respectively, while those in non-THE group were 84.5%, 49.2%, 37.2%, and 28.7%, respectively. The THE group showed better long-term survival than the non-THE group, however the difference was not statistically significant. Conclusion THE is a safe alternative for esophageal carcinoma and esophagogastric junction cancer.国家自然科学基金; 北京学科带头人计划; 北京市自然科学基金; 首都发展基金PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)09649-6511