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[胃癌患者手术治疗后肿瘤学结局的危险因素:1031例患者的多变量分析]

[Risk factors for oncologic outcome after surgical treatment in patients with gastric cancer: a multivariable analysis of 1031 patients].

作者信息

Li Xiao-bao, Zhang Hong-wei, Zhao Qing-chuan, Dong Guang-long, Wang Wei-zhong

机构信息

Department of Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Feb;13(2):115-8.

Abstract

OBJECTIVE

To investigate the risk factors for the prognosis in patients with gastric cancer undergoing surgery.

METHODS

Clinical data of 1031 cases who underwent gastric cancer resection from January 2003 to December 2007 were studied using univariable analysis and multivariable regression analysis.

RESULTS

In 1031 cases,95 (9.2%) cases were early-stage gastric cancer. The other 936 (90.8%) cases were advanced gastric cancer. The tumor was resectable in 980 (95.1%) cases, of which 874 (84.8%) were curative resection,106 (10.3%) were palliative, and 51 (4.9%) were bypass procedures or laparotomy alone. The stage-specific 5-year survival rates were 93.2% (stage IA), 65.1%(stage IB), 52.3% (stage II), 41.4% (stage IIIA), 16.6% (stage IIIB) and 10.6% (stage IV), respectively. The 1-, 3- and 5-year survival rates were 80.2%, 58.0% and 48.2%, respectively. The independent risk factors associated with the prognosis of these patients were tumor size, serum albumin, curative resection, TNM staging and multidisciplinary treatment in both univariable and multivariable analyses.

CONCLUSIONS

Early curative resection is the most important treatment for the patients with gastric cancer. Individualized surgical procedure combined with multidisciplinary treatment can improve the outcome. Tumor size, serum albumin level and TNM staging are important predictors of survival in patients with gastric cancer.

摘要

目的

探讨接受手术治疗的胃癌患者预后的危险因素。

方法

对2003年1月至2007年12月期间接受胃癌切除术的1031例患者的临床资料进行单因素分析和多因素回归分析。

结果

1031例患者中,95例(9.2%)为早期胃癌。其余936例(90.8%)为进展期胃癌。980例(95.1%)肿瘤可切除,其中874例(84.8%)为根治性切除,106例(10.3%)为姑息性切除,51例(4.9%)为单纯旁路手术或剖腹探查术。各分期的5年生存率分别为93.2%(IA期)、65.1%(IB期)、52.3%(II期)、41.4%(IIIA期)、16.6%(IIIB期)和10.6%(IV期)。1年、3年和5年生存率分别为80.2%、58.0%和48.2%。单因素和多因素分析显示,与这些患者预后相关的独立危险因素为肿瘤大小、血清白蛋白、根治性切除、TNM分期和多学科治疗。

结论

早期根治性切除是胃癌患者最重要的治疗方法。个体化手术联合多学科治疗可改善预后。肿瘤大小、血清白蛋白水平和TNM分期是胃癌患者生存的重要预测因素。

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