胃癌根治性远端胃切除术后淋巴结清扫数目对生存的影响。

Effect of negative lymph node count on survival for gastric cancer after curative distal gastrectomy.

机构信息

Department of Oncology, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, Fujian Province, PR China.

出版信息

Eur J Surg Oncol. 2011 Jun;37(6):481-7. doi: 10.1016/j.ejso.2011.01.012. Epub 2011 Mar 2.

DOI:10.1016/j.ejso.2011.01.012

PMID:21371852

Abstract

AIMS

The aim of this study is to evaluate the long-term effect of negative lymph node (LN) counts on the prognosis after curative distal gastrectomy among gastric cancer patients.

METHODS

The study enrolled 634 patients with gastric cancer, who had undergone curative resection (R0) with distal gastrectomy from 1995 to 2004. Long-term surgical outcomes and relationships between the negative LN count and the 5-year survival rate were investigated.

RESULTS

The 5-year survival rate of the entire cohort was 57.6%. The number of metastasis negative LN was positively associated with the retrieved node according to the Pearson's correlation test (P < 0.001). Cox regression analysis showed the negative LN count was an independent predictor of survival (P < 0.05). Based on the statistical assumption the best fitting linear, linear regression showed a significant survival improvement based on increasing negative LN count for patients with stages I (P = 0.014), II (P = 0.011) and III (P = 0.003). The greatest survival differences were observed at cutoff value 10 negative LN counts for stage I, and 15 for stages II, III and IV.

CONCLUSION

Negative LN counts can reflect the extent of lymphadenectomy for gastric cancer after curative distal gastrectomy. The higher the negative LN count, the better the survival would be; the best long-term survival outcome was observed on the negative LN count more than 10 (stage I) or 15 (stages II, III, and IV).

摘要

目的

本研究旨在评估胃癌患者根治性远端胃切除术后阴性淋巴结（LN）计数对预后的长期影响。

方法

本研究纳入了 1995 年至 2004 年间接受根治性远端胃切除术（R0）的 634 例胃癌患者。研究了长期手术结果以及阴性 LN 计数与 5 年生存率之间的关系。

结果

全队列的 5 年生存率为 57.6%。Pearson 相关检验显示，转移阴性 LN 的数量与检出的淋巴结呈正相关（P<0.001）。Cox 回归分析显示，阴性 LN 计数是生存的独立预测因素（P<0.05）。基于统计学假设，最佳拟合线性，线性回归显示，对于 I 期（P=0.014）、II 期（P=0.011）和 III 期（P=0.003）患者，随着阴性 LN 计数的增加，生存显著改善。在截断值为 10 个阴性 LN 计数时，I 期的生存差异最大，在 II、III 和 IV 期为 15 个。