Mikami Koji, Maekawa Takafumi, Shinohara Tetuo, Hoshino Seiichiro, Yamauchi Yasushi, Noritomi Tomoaki, Yamashita Yuichi
Second Department of Surgery, School of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonanku, Fukuoka 814-0180, Japan.
Int Surg. 2009 Apr-Jun;94(2):144-8.
Although several prognostic factors for gastric cancer have been shown, the predictive factors of early recurrent death remain to be elucidated. This study included 402 patients who underwent a curative resection for gastric cancer. Fifty-six patients died of recurrence. A multivariate analysis was performed to determine the independent factors correlated with survival time. The patients with an elevation of tumor markers, tumors in the upper one third of the stomach, deep wall invasion (T3, T4), extended lymph node metastases (N2, N3), an advanced stage (stages III and IV), and operation (total gastrectomy) showed a significantly different survival time. According to a multivariate analysis, the survival time was independently associated with tumor location, tumor markers, and lymph node metastases. The patients with tumors in the upper one third of the stomach, elevated tumor markers, and extended lymph node metastases can not be controlled by surgery alone.
尽管已经发现了几种胃癌的预后因素，但早期复发死亡的预测因素仍有待阐明。本研究纳入了402例行胃癌根治性切除术的患者。56例患者死于复发。进行多因素分析以确定与生存时间相关的独立因素。肿瘤标志物升高、胃上三分之一肿瘤、壁层深层浸润（T3、T4）、广泛淋巴结转移（N2、N3）、晚期（III期和IV期）以及手术（全胃切除术）的患者生存时间有显著差异。根据多因素分析，生存时间与肿瘤位置、肿瘤标志物和淋巴结转移独立相关。胃上三分之一有肿瘤、肿瘤标志物升高且有广泛淋巴结转移的患者仅靠手术无法得到控制。
