Chi Zhen, Huang Chang-ming, Zheng Chao-hui, Li Ping, Xie Jian-wei, Wang Jia-bin, Lin Jian-xian
Department of Surgical Oncology, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2011 Feb;14(2):114-6.
To investigate the impact of tumor size on the prognosis of patients with T3 gastric cancer.
D2 curative resection was performed on 408 patients with T3 gastric cancer. Cox proportional hazards model was used to identify the optimal cut-off of tumor size. Potential prognostic factors were evaluated by univariate and multivariate analysis. Multivariate analysis was performed to evaluate the prognostic factors stratified by tumor size.
Among 408 patients with T3 gastric cancer, Cox proportional hazards model showed that 8 cm was the optimal cut-off of tumor size. There were 85 patients with tumor size ≥8 cm(large size group), and 323 patients with tumor size <8 cm(small size group). The 5-year survival rate was significantly lower for patients with small size tumor(33.8% vs. 52.2%, P<0.05). Cox proportional hazards model showed that lymph node metastasis, tumor size, and Borrmann type were independent prognostic factors for the entire cohort. Borrmann type IIII( and N2-3 nodal metastasis were independent prognostic factors for the large size group. Lymph node metastasis was independent prognostic factor for the small size group.
Tumor size is an independent prognostic factor in patients with T3 gastric cancer. Lymph node metastasis is a significant predictor for the prognosis regardless of tumor size. Furthermore, Borrmann classification is associated with the prognosis in patients with tumor size ≥8 cm.
探讨肿瘤大小对T3期胃癌患者预后的影响。
对408例T3期胃癌患者行D2根治性切除术。采用Cox比例风险模型确定肿瘤大小的最佳截断值。通过单因素和多因素分析评估潜在的预后因素。进行多因素分析以评估按肿瘤大小分层的预后因素。
在408例T3期胃癌患者中，Cox比例风险模型显示8 cm为肿瘤大小的最佳截断值。肿瘤大小≥8 cm的患者有85例（大尺寸组），肿瘤大小<8 cm的患者有323例（小尺寸组）。小尺寸肿瘤患者的5年生存率显著较低（33.8%对52.2%，P<0.05）。Cox比例风险模型显示，淋巴结转移、肿瘤大小和Borrmann分型是整个队列的独立预后因素。Borrmann III/IV型和N2-3淋巴结转移是大尺寸组的独立预后因素。淋巴结转移是小尺寸组的独立预后因素。
肿瘤大小是T3期胃癌患者的独立预后因素。无论肿瘤大小如何，淋巴结转移都是预后的重要预测指标。此外，Borrmann分型与肿瘤大小≥8 cm患者的预后相关。
