摘要
目的:探讨影响进展期胃癌患者根治术预后的相关危险因素。方法:回顾性分析675例进展期胃癌患者行根治术后的临床资料,采用Kaplan-Meier单因素分析法和Cox比例风险模型多因素方法分析。结果:全组术后1、3、5年累积复发率分别为27.7%、67.9%和84.4%,中位复发时间为31.7个月。其中局部复发占29.1%,腹膜复发占52.6%,血源性复发占18.3%。1、3、5年总体生存率分别为88.2%、54.5%和36.7%。单因素分析显示肿瘤Borrmann分型、浸润深度、淋巴结转移、组织学类型、TNM分期、切缘情况及是否接受辅助放化疗是影响患者预后的因素(P<0.05)。多因素分析表明组织学类型、TNM分期、切缘情况是影响进展期胃癌根治性切除术后预后的独立危险因素(P<0.05)。结论:组织学类型、TNM分期、切缘情况是进展期胃癌根治性切除术后影响生存的独立危险因素;D2根治性切除进展期胃癌结合辅助性放化疗可进一步改善患者预后。
Objective： To explore risk factors of prognosis on advanced gastric cancer patients after surgical radical resection and study its impact on patients long-term prognosis.Methods： Clinical data were analyzed from 675 patients who underwent surgical radical resection for advanced gastric cancer.Potential clinicopathological prognostic factors were examined by Kaplan-Meier univariate and Cox proportional hazards model regression multivariate analysis.Results： The 1,3 and 5 years cumulative recurrence rate was 27.7%,67.9% and 84.4% respectively（median recurrence time was 31.7 months）.Which accounted for 29.1% of local recurrence,52.6% of peritoneal recurrence and 18.3% of blood-borne recurrence.The 1,3 and 5 years overall survival rate was 88.2%,54.5% and 36.7% respectively.Univariate analysis revealed tumor Borrmann type,depth of invasion,lymph node metastasis,histological type,TNM stage,surgical margin and adjuvant chemotherapy were significant factors influencing patients prognosis（P〈0.05）.Multivariate analysis revealed histological type,TNM stage and surgical margin were significant independent predictors of poor prognosis（P〈0.05）.Conclusion： Histological type,TNM stage and surgical margin were the most important prognostic factors for advanced gastric carcinoma after surgical radical resection.United D2 radical resection of advanced gastric cancer and adjuvant chemotherapy may further improve the prognosis.
出处
《东南大学学报（医学版）》
CAS
2011年第6期909-914,共6页
Journal of Southeast University(Medical Science Edition)
关键词
进展期胃肿瘤
根治术
预后
危险因素
advanced gastric neoplasms
radical mastectomy
prognosis
risk factor
