关键词: ESCC esophageal fistula esophagomediastinal fistula esophagorespiratory fistula prognostic factor survival

Mesh : Adult Aged Aged, 80 and over Biomarkers / blood China / epidemiology Esophageal Fistula / diagnosis epidemiology mortality Esophageal Neoplasms / diagnosis epidemiology mortality Esophageal Squamous Cell Carcinoma / diagnosis epidemiology mortality Female Hemoglobins / analysis Humans Incidence Male Middle Aged Prognosis Retrospective Studies Risk Assessment Risk Factors Sex Factors Time Factors

来  源:   DOI:10.1042/BSR20193379   PDF(Pubmed)

Abstract:
The aim of the present study was to investigate the survival and prognostic factors of patients who were with advanced esophageal squamous cell carcinoma (ESCC) and developed an esophageal fistula. The data from 221 patients with advanced ESCC developed esophageal fistula from January 2008 to December 2017 at the Harbin Medical University Cancer Hospital was retrospectively analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by the Cox proportional hazard models. The median survival time after a diagnosis of the esophageal fistula was calculated using the Kaplan-Meier method. We found that the pathogens infected by patients are common bacteria in nosocomial infection. Besides, the incidence rate of esophagomediastinal fistula was the highest (54.2%) in the lower third of the esophagus. Kaplan-Meier analysis revealed a median survival time of 11.00 months and a median post-fistula survival time of 3.63 months in patients who developed esophageal fistula in advanced esophageal cancer. In the univariate analysis, gender, therapies for ESCC before the development of fistula, type of esophageal fistula, treatment of esophageal fistula and hemoglobin (Hb) level were the factors with significant prognostic value. Gender, type of esophageal fistula and Hb level were identified as independent prognostic factors in further multivariate analysis. In summary, our study demonstrated that several factors are significantly related to patients with esophageal fistula and should be concerned about in clinical practice.
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