https://scholars.lib.ntu.edu.tw/handle/123456789/562498
標題: | The role of bronchoscopic assessment in esophageal cancer - Clinical and survival analysis in 153 patients | 作者: | Cheng S.-L. HAO-CHIEN WANG Lee Y.-C. PAN-CHYR YANG Kuo S.-H. KWEN-TAY LUH |
公開日期: | 2005 | 卷: | 104 | 期: | 3 | 起(迄)頁: | 168-173 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background and Purpose: The diagnostic value and indications for fiberoptic bronchoseopy in the preoperative assessment of patients with esophageal cancer have not been fully studied. We evaluated the role of fiberoptic bronchoscopic examination in the stage work-up of patients with esophageal cancer and correlated the results with survival time analysis. Methods: The medical records of 158 patients with an initial diagnosis of esophageal cancer were reviewed. Clinical data, bronchoscopic findings, treatment courses, and survival time of these patients were analyzed. Results: On initial bronchoscopic examinations, distortion/compression of the normal structure and protrusion at the posterior wall of the trachea or bronchus were the most common bronchoscopic findings (35.9%). We stratified patients into 3 subgroups according to bronchoscopic findings of direct invasion, external compression, and negative findings. The symptoms of dyspnea, hoarseness, aspiration and fever were more frequent in patients with direct airway invasion compared with patients with external compression and negative bronchoscopic findings (p < 0.02). Washing and brushing cytology examinations were all negative in patients with external compression of the airway. There was a significant difference of survival time among these 3 groups of patients (direct invasion: 5.6 ± 0.6 months; external compression; 12.3 ± 0.9 months; negative findings: 13.3 ± 1.1 months, p < 0.01). Direct airway invasion and original cancer stage were the most important variables for survival in the multivariate analysis, and the hazard ratio for prognosis was 2,5 (95% confidence interval [CI], 1.1-4.6) and 4.2 (95% CI, 1.5-9.3), respectively. Twelve patients (80%) with tracheoesaphageal (TE) fistulae died within 3 months after diagnosis due to aspiration pneumonia and septic shock. Conclusions: The role of bronchoscopic examination in patients with esophageal cancer for preoperative evaluation resides in its ability to predict airway invasion and its impact on survival. Advanced cancer stage (stage IV) and direct airway invasion (especially TE fistula) were significantly associated with poor prognosis. These results suggest that patients suffering from dyspnea, hoarseness, aspiration and fever, implicating a high probability of airway invasion, are more likely to benefit from bronchoscopic examination and proper management in order to prevent aspiration or complications. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/562498 | ISSN: | 0929-6646 | SDG/關鍵字: | cisplatin; fluorouracil; adjuvant therapy; adult; aged; aspiration pneumonia; bronchospasm; cancer radiotherapy; cancer staging; cancer surgery; cancer survival; clinical assessment; controlled study; cytology; dyspnea; esophagus cancer; female; fever; fiberoptic bronchoscopy; hazard assessment; hoarseness; human; major clinical study; male; medical record; prognosis; review; septic shock; survival time; trachea compression; tracheoesophageal fistula; article; bronchoscopy; cancer invasion; chi square distribution; esophagus tumor; fiber optics; middle aged; pathology; proportional hazards model; retrospective study; survival; Taiwan; Bronchoscopy; Chi-Square Distribution; Esophageal Neoplasms; Female; Fiber Optics; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Proportional Hazards Models; Retrospective Studies; Survival Analysis; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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