Nazli Okay, Derici Hayrullah, Tansug Tugrul, Yaman Ismail, Bozdag Ali Dogan, Isgüder Ali Serdar, Bölükbasi Hakan
Third Surgical Clinic, Atatürk Training and Research Hospital, Izmir, Turkey.
Hepatogastroenterology. 2007 Mar;54(74):625-9.
BACKGROUND/AIMS: This study was performed to evaluate major morbidity, early mortality and to analyze survival in our patients that underwent surgical treatment for gastric cancer.
Records of 121 patients with gastric adenocarcinoma that underwent surgery between 1997 and 2004 were reviewed retrospectively. Age, gender, tumor site, presence of local invasion, depth of tumor invasion, lymph node metastases, stage of the disease, distant metastases, histological differentiation, type of surgery, and blood transfusions were evaluated in relation to survival. Survival curves were estimated using the Kaplan-Meier method and the differences in survival were compared by the log-rank test.
Forty-two cases (34.7%) underwent total gastrectomy, 34 (28.1%) had subtotal gastrectomy, and 45 (37.2%) received palliative surgery. The majority of the patients (61.2%) had stage IV gastric cancer. Total morbidity and mortality were 26.4% and 17.3%, respectively. The factors that influence survival were type of surgery, adjacent organ invasion, existence of metastases, lymph node status, blood transfusions, and stage of the disease in this study. Among the significant prognostic factors in the univariate analysis, only one factor, R0 resection proved to be independently significant in the multivariate analysis.
R0 resection was found to have a significant favorable effect on survival in our study.
背景/目的:本研究旨在评估接受胃癌手术治疗患者的主要发病率、早期死亡率,并分析其生存率。
回顾性分析1997年至2004年间接受手术治疗的121例胃腺癌患者的病历。评估年龄、性别、肿瘤部位、局部侵犯情况、肿瘤侵犯深度、淋巴结转移、疾病分期、远处转移、组织学分化程度、手术类型及输血情况与生存率的关系。采用Kaplan-Meier法估计生存曲线,并通过对数秩检验比较生存率差异。
42例(34.7%)患者接受了全胃切除术,34例(28.1%)行胃次全切除术,45例(37.2%)接受了姑息性手术。大多数患者(61.2%)为IV期胃癌。总发病率和死亡率分别为26.4%和17.3%。本研究中影响生存的因素包括手术类型、邻近器官侵犯、转移情况、淋巴结状态、输血及疾病分期。在单因素分析的显著预后因素中,多因素分析显示只有R0切除这一因素具有独立显著性。
本研究发现R0切除对生存率有显著的有利影响。