| Objective: It is well known, the most effective treatment for the patients with thoracic esophageal carcinoma and gastroesophageal junction carcinoma was radical surgery. But a lot of factors affect the prognosis, including clinical, pathological and many other aspects. There is no uniform standard of gastroesophageal junction carcinoma ,so our preliminary study made the gastroesophageal junction carcinoma as part of thoracic esophageal carcinoma, summarized our hospital clinical material based on reviewing the literature of domestic and foreign, and application of Cox proportional risk model analysis. But gastroesophageal junction carcinoma has its own independent autopsy and histopathological characteristics, can be seemed as a disease independent, so this study will be separated to two further analysis in order to thoroughly understand the prognosis of thoracic esophageal cancinoma and gastroesophageal junction carcinoma. Method: According to the selection criteria, the data hospitalized patients with the thoracic esophageal carcinoma and gastroesophageal junction carcinoma in the Fourth Hospital of Hebei Medical University from January 1996 to December 2004 were reviewed. The cases arranged by case No.and according to 4:1 for a sample, we selected 1574 casses.The questionnaires were input to ACESS database after it was encoded. We used random sampling method and selected 1414 cases to do this study. A follow-up study was carried out on the sample, and follow-up was made by post letter, phone-call in those patients. For the follow-up, the operation time was looked as the starting point and the end point was missing or lately time of follow-up. In the study, dead from cancer was the termination.Reference to some other studies, we collected fifteen possible factors influencing survival of these patients. All analyses were performed by using SPSS13.0 software package. Chi-square test was used for the enumeration data to comparison, and the univariate and multivariate analysis of these individual variables were performed by Cox proportional hazard model. All tests were performed at the 0.05 level of significances.Result: We randomly selected 1414 cases to be follow-up,906 cases were visited,575 cases for thoracic esophageal carcinoma and 331 cases for gastroesophageal junction carcinoma.The results of this study were as follows: 1 Thoracic esophageal carcinoma 1.1 The cox analysis of thoracic esophageal carcinoma Multivariate analysis confirmed the pathological classification, clinical stage, lymph node metastasis number, lesion length, the nearby organs involved as independent prognostic factors.1.2 Thoracic esophageal squamous cell carcinoma cox analysis: clinical stage, number of lymph node metastasis, lesion length, the nearby organs involved as independent prognostic factors.1.3 The cox analysis of different part of thoracic esophageal carcinoma1.3.1 Upper: age, depth of invasion, whether the tumor thrombus are independent prognostic factors.1.3.2 Middle:lesion leng,pathological classification, number of lymph nodes metastasis, the depth of invasion and the nearby organs involved are independent prognostic factors.1.3.3 Thoracic segment: the number of lymph node metastasis is independent prognostic factors.1.4 The cox analysis of different clinical stages of thoracic esophageal carcinoma1.4.1 StageⅡ: age, length of lesion, pathological classification, the nearby organs involved and treatment situation as independent prognostic factors.1.4.2 StageⅢ: tumor location, number of lymph node metastasis are independent prognostic factors.1.5 Multivariate analysis confirmed pathological classification, lesion length, the nearby organs involved, the treatment situation as independent prognostic factors of thoracic esophageal carcinoma of stageN0.1.6 In different invasion depth analysis of thoracic esophageal cancer cox1.6.1 Stage T2: pathological classification, lesion length, number of lymph node metastasis and the nearby organs involved are independent prognostic factors.1.6.2 Stage T3: number of lymph node metastasis and the nearby organs involved are independent prognostic factors.1.6.3 Stage T4:only the number of lymph node metastasis is independent prognostic factor.1.7 Cox analysis of different length of thoracic esophageal carcinoma1.7.1 Lesion length≤3cm: clinical stage, the nearby organs involved as prognostic factors.1.7.2 Lesion length of 3.1-5cm: pathological classification, clinical stage, the nearby organs involved as prognostic factors.1.7.3 Lesion length of 5.1-7cm,> 7cm: independent prognostic factor is the number of lymph node metastasis.2 Gastroesophageal junction carcinoma2.1 The cox analysis of gastroesophageal junction carcinoma Multivariate analysis confirmed the clinical stage, the nearby organs involved as independent prognostic factors.2.2 Cox analysis of adenocarcinoma of GEJ carcinoma: clinical stage, the nearby organs involved as independent prognostic factors.2.3 Factor analysis confirmed that only the nearby organs involved for stageⅢGEJ carcinoma independent prognostic factor.2.4 Different lymph node metastasis at the GEJ carcinoma cox analysis2.4.1 N0 period: the nearby organs involved, clinical stage as independent prognostic factors.2.4.2 Non-N0 period: gender as an independent prognostic factor.2.5 Different depth of infiltration at the GEJ carcinoma cox analysis2.5.1 T2 period: clinical stage as independent prognostic factor.2.5.2 T4 period: pathological classification, number of lymph node metastasis, stump,the nearby organs involved are independent prognostic factors.2.6 Different lesion length of GEJ carcinoma cox analysis2.6.1≤3cm: clinical stage as independent prognostic factor.2.6.2 5.1-7cm: the number of lymph node metastasis, stump, the nearby organs involved are independent prognostic factors.2.6.3 > 7cm: pathological classification and vascular tumor thrombus are independent prognostic factors.Conclusion:1 The independent prognostic factors for thoracic esophageal carcinoma are pathological classification, clinical stage, the number of lymph node metastasis, lesion length and the nearby organs involved; for GEJ carcinoma the independent prognostic factors are clinical staging and the nearby organs involved. 2 In different sites, clinical stages, depth of invasion, lesion length of thoracic esophageal carcinoma there are different independent prognostic factors; and for GEJ carcinoma,the length of different lesions, lymph node metastasis, depth of invasion have their own separate prognostic factors.3 At the same stage, depth of invasion, lesion length and other aspects,thoracic esophageal carcinoma and GEJ carcinoma have come to the independence of different prognostic factors.4 Esophageal squamous cell carcinoma's independent prognostic factors are exactly the same with thoracic esophageal carcinoma; similarly, the adenocarcinoma of GEJ carcinoma has the same independent prognostic factors with GEJ carcinoma.
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