Multivariate Analysis Of Factors Affecting The Survival Status Of Patients With Esophageal Cancer

Objective: This study was designed to investigate the influencing factors of chemotherapy efficacy in patients with advanced esophageal cancer.Methods: This study retrospectively analyzed patients with advanced esophageal cancer who have underwent palliative chemotherapy at the Fourth Hospital of Hebei Medical University from 2013-1-1 to 2017-6-30.Kaplan-Meier,log-rank test,and COX test were used to evaluate the relationship between clinical characteristics(gender,age,location,extent,histology,surgery,ECOG score,and antibiotics)and progression-free survival(PFS),overall survival(OS).Results:1.Univariate and multivariate analysis for clinical characteristics associated with PFS: The clinical characteristics including gender(P=0.663),age(P=0.378),lesion(P=0.954),range(P=0.494),ECOG score(P=0.252),and surgery(P=0.668)had no statistical effect on PFS.The PFS of the control group was significantly longer than that of the antibiotic group(P=0.007,median PFS 17.1 month VS 9.2 months).The PFS of squamous cell carcinoma patients was significantly longer than that of the non-squamous cell carcinoma patients(P<0.001,median PFS 13.9 months VS 3 months).Pathology(P<0.001,HR=0.118,95%CI:0.037-0.378)and antibiotics(P=0.019,HR=2.215,95%CI:1.130-3.993)were independent prognostic factors for PFS.2.Univariate and multivariate analysis for clinical characteristics associated with OS: The clinical characteristics including gender(P=0.765),lesion(P=0.977),range(P=0.756),ECOG score(P=0.586),and surgery(P=0.595)had no statistical effect on OS.OS in the control group was significantly longer than that of the antibiotic group(P=0.044,median OS >60 months VS 24 months).The OS of patients who were younger than or equal to 60 years old was significantly longer than that in the patients who were older than 60 years(P=0.011,median OS >60 months VS 21 months),The OS of squamous cell carcinoma patients were significantly longer than patients with non-squamous cell carcinoma(P<0.001,median OS >60 months VS 6.9 months).Antibiotics(P=0.017,HR=2.731,95%CI :1.198-6.222),age(P=0.027,HR=0.376,95%CI:0.158-0.893),and pathology(P=0.001,HR=0.108,95%CI:0.028-0.423)were independent prognostic factors for OS.3.The disease control rate of the control group was significantly higher than that of the antibiotic group(P=0.025).4.The Hierarchical analysis in the antibiotic group: The clinical characteristics including type of antibiotic(P=0.863),antibiotic administration(P=0.547),duration of antibiotic treatment(P=0.779),indication(therapeutic antibiotics and prophylactic antibiotics)(P=0.346)and infection site(P=0.665)had no significant difference on PFS of patients with advanced esophageal cancer.The clinical characteristics including type of antibiotic(P=0.259),antibiotic administration(P=0.246),duration of antibiotic treatment(P=0.282),indication(therapeutic antibiotics and prophylactic antibiotics)(P=0.297)and infection site(P=0.179)had no significant difference on OS of patients with advanced esophageal cancer.Conclusion:1.Clinical characteristics including age less than or equal to 60 years old,pathological types of small cell carcinoma and sarcomatoid carcinoma and antibiotics within 60 days before and after chemotherapy can reduce the prognosis of patients with advanced esophageal cancer.2.The disease control rate of the antibiotic group was significantly lower than that of the control group.3.The type of antibiotics,the antibiotic administration,the duration of antibiotic treatment,indication(therapeutic antibiotics and prophylactic antibiotics)and the site of infection had no effect on the prognosis of patients with advanced esophageal cancer.