A Research of Factors Determing the Prognosis of Patients with Esophageal Cancer using Multivariate Analysis -By Cox's Proportinal Hazards Model-

Takeshi Endo

Division of Surgery, The Institute of Gastroenterology, Tokyo Women's Medical College

Many factors determined the prognosis of patients with esophageal cancer. These are divided into tumor factors, physical factors (age, sex, etc), and therapeutic factors based on "Guidelines for Clinical and Pathologic Studies on Carcinoma of the Esophagus (7th Edition)". It is necessary to analyze interrelated factors because several factors may affect probability of different survival. I selected factors governing prognosis and reviewed the degree to which these were associated the prognosis using the PHGLM procedure (SAS package). The aim of this report is to enable selection of the best therapy for esophageal cancer. I analyzed 410 cases in which the surgical approach was the right thorax and abdomen, excluding absolute non-curative cases and ep-mm cancer. The cases were classified into two groups, patients in Group A were operated between 1980 two 1984 underwent dissection in 2 fields, the abdominal and thoracic cavities, and patients in Group B underwent surgery from 1985 onwards, occasionally in 3 fields, the 2 fields plus the cervical region, based on various methods of imaging diagnosis. The results revealed the following prognostic factors: n-factor, CAT, SAT, INF, and intramural metastasis. With respect to the n-factor, it's necessary to consider the total number of metastatic lymph nodes and type of metastasis in Im cancer. The factors improving prognosis are posterior operation. Postoperative radiotherapy and adjuvent chemotherapy were ineffective.

Key words
prognostic factor of esophageal cancer, multivariate analysis, 3 field dissection of esophageal cancer, adjuvant therapy for esophageal cancer

Reprint requests
Takeshi Endo Division of Surgery, The Institute of Gastroenterology, Tokyo Women's Medical College
8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
February 12, 1992

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