Gastrointestinal Cancer Surgery Division, Tianjin Medical University Cancer Hospital and City Key Laboratory of Tianjin Cancer Center, Tianjin, China.
J Surg Res. 2010 Jun 1;161(1):47-53. doi: 10.1016/j.jss.2008.12.019. Epub 2009 Jan 10.
The purpose of this study was to evaluate the appropriate prognostic indicators of lymph node-positive gastric cancer patients following curative resection.
A retrospective study of 196 lymph node-positive patients who underwent radical gastrectomy (R0) for gastric cancer from January 1997 to December 2000 was analyzed statistically to identify the intensive indictors of prognosis.
In 196 evaluable patients, 5-year survival rate was 33.2%. A total of 4048 lymph nodes were examined (median, 20.6; range, 15-49), and 1661 lymph nodes were positive (median, 8.5; range, 1-37). The median survival was 29 months. With multivariate analysis, we found number and ratio of metastatic lymph nodes were associated with overall survival (OS) of lymph node-positive patients after curative surgery. However, we ultimately identified that ratio of metastatic lymph nodes was more appropriate to evaluate OS of lymph node-positive patients than number of metastatic lymph nodes by using the case-control matched fashion. One hundred forty-four (73.5%) patients had recurrence after curative surgery. The median disease-free time was 18 month, and the median survival after recurrence was 4 month. With multivariate analysis (logistic regression model), we found number of metastatic lymph nodes was associated with recurrence after curative surgery.
Ratio and number of metastatic lymph nodes were important indicators of OS and recurrence of lymph node-positive gastric cancer patients following curative resection, respectively.
本研究旨在评估行根治性切除术的淋巴结阳性胃癌患者的适当预后指标。
对 1997 年 1 月至 2000 年 12 月期间因胃癌行根治性胃切除术（R0）的 196 例淋巴结阳性患者进行回顾性研究，以统计分析确定预后的强化指标。
在 196 例可评估患者中，5 年生存率为 33.2%。共检查了 4048 个淋巴结（中位数为 20.6；范围为 15-49），其中 1661 个淋巴结阳性（中位数为 8.5；范围为 1-37）。中位生存时间为 29 个月。多因素分析发现，转移淋巴结的数量和比例与根治性手术后淋巴结阳性患者的总生存（OS）相关。然而，我们最终通过病例对照匹配的方式发现，转移淋巴结的比例比转移淋巴结的数量更适合评估淋巴结阳性患者的 OS。144 例（73.5%）患者在根治性手术后复发。无病时间的中位数为 18 个月，复发后的中位生存时间为 4 个月。多因素分析（逻辑回归模型）发现，转移淋巴结的数量与根治性手术后的复发相关。
转移淋巴结的比例和数量是淋巴结阳性胃癌患者根治性手术后 OS 和复发的重要指标。
