METHODS: Data were collected from 48 patients who underwent curative surgery for esophageal MEC at the Fourth Hospital of Hebei Medical University between January 1, 2004, and December 31, 2020. These were compared with contemporaneous cases of Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC). Using the Kaplan-Meier method and multivariate Cox regression analysis, we investigated the clinicopathological factors affecting the survival of patients with MEC.
RESULTS: The incidence of MECE was predominantly higher in males, with a male-to-female ratio of approximately 7:1. The mid-thoracic segment emerged as the most common site of occurrence. A mere 6.3% of cases were correctly diagnosed preoperatively. The lymph node metastasis rate stood at 35.4%. The overall 1-year, 3-year, 5-year, and 10-year survival rates for all patients were 85.4%, 52.1%, 37.0%, and 31.0%, respectively. Post 1:1 propensity score matching, no significant statistical difference was observed in the Overall Survival (OS) between MEC patients and those with Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC) (P = 0.119, P = 0.669). Univariate analysis indicated that T staging and N staging were the primary factors influencing the prognosis of esophageal MEC.
CONCLUSIONS: MECE occurs more frequently in males than females, with the mid-thoracic segment being the most common site of occurrence. The rate of accurate preoperative endoscopic diagnosis is low. The characteristic of having a short lesion length yet exhibiting significant extramural invasion may be a crucial clinicopathological feature of MECE. The OS of patients with MEC does not appear to significantly differ from those with esophageal squamous carcinoma and adenocarcinoma.
方法:收集2004年1月1日至2020年12月31日在河北医科大学第四医院接受食管MEC根治性手术的48例患者的资料。将这些与同期的食管鳞状细胞癌(ESCC)和食管腺癌(EAC)病例进行比较。采用Kaplan-Meier方法和多元Cox回归分析,我们调查了影响MEC患者生存的临床病理因素.
结果:男性MECE的发生率主要较高,男女比例约为7:1。胸中段是最常见的发生部位。只有6.3%的病例在术前得到正确诊断。淋巴结转移率为35.4%。整体1年,3年,5年,所有患者的10年生存率为85.4%,52.1%,37.0%,和31.0%,分别。后1:1倾向得分匹配,MEC患者与食管鳞状细胞癌(ESCC)和食管腺癌(EAC)患者的总生存期(OS)差异无统计学意义(P=0.119,P=0.669)。单因素分析显示T分期和N分期是影响食管MEC预后的主要因素。
结论:男性比女性更频繁地发生MECE,胸中段是最常见的发生部位。术前内镜诊断准确率低。病变长度短但表现出明显的壁外侵袭的特征可能是MECE的关键临床病理特征。MEC患者的OS与食管鳞癌和腺癌患者的OS没有显着差异。