Endoscopic ultrasonography and prognosis of esophageal cancer.
Endoscopic ultrasonography and prognosis of esophageal cancer.
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食管癌的超声内镜检查与预后。
DOI：
10.1016/j.cgh.2006.03.027
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Cooper,GregoryS
中科院分区：
文献类型：
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作者：
Das,Ananya;Chak,Amitabh;SivakJr,MichaelV;Payes,Jonathan;Cooper,GregoryS
背景与目的超声内镜（EUS）分期用于食管癌的治疗，但其对患者预后的影响尚不清楚。我们的目的是研究EUS和总生存率在一个队列中的患者食管cancer.MethodsAll的人谁被诊断为食管癌65岁或以上，1994年1月至1999年12月之间的监测，流行病学和最终结果（SEER）-医疗保险链接的数据库的接收的关联。相关的人口统计学，癌症的具体信息和EUS程序的信息extracted.ResultsTwo 830例食管癌（48%鳞状细胞癌）有资格进行分析。仅303例（10.7%）患者接受了EUS检查。接受EUS评估的患者更可能接受食管切除术（21.1% vs 14.7%，P = 0.01），更可能接受辅助治疗（11.2% vs 6.7%，P = 0.008）。当调整诊断时的年龄、种族、性别、合并症、组织学和肿瘤分期后，接受EUS与死亡风险降低相关（相对危险度，0.594; 95%可信区间，0.52-0.68; P = .001）。结论食管癌患者接受EUS治疗与生存率提高独立相关，这可能是因为改善了分期适当的管理，如使用辅助治疗和手术切除。
Background & AimsEndoscopic ultrasonography (EUS) staging is used for management of esophageal cancer, but its effect on the outcome of patients is unknown. Our aim was to study the association of receipt of EUS and overall survival in a cohort of patients with esophageal cancer.MethodsAll persons 65 years or older who were diagnosed with esophageal cancer between January 1994 and December 1999 in the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database were identified. Relevant demographic, cancer-specific information and EUS procedural information were extracted.ResultsTwo thousand eight hundred thirty patients with esophageal cancer (48% squamous cell cancer) were eligible for analysis. Only 303 (10.7%) patients underwent a EUS examination. Patients who had EUS evaluation were more likely to undergo esophageal resection (21.1% vs 14.7%, P = .01) and more likely to have received adjuvant therapy (11.2% vs 6.7%, P = .008). When adjusted for age at diagnosis, race, gender, comorbidity, histology, and tumor stage, receipt of EUS was associated with a reduced risk of death (relative hazard, 0.594; 95% confidence interval, 0.52–0.68; P = .001).ConclusionsUndergoing EUS in patients with esophageal cancer is independently associated with improved survival, possibly because of improved stage-appropriate management such as use of adjuvant therapy and surgical resection.