Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
Gastric Cancer. 2011 Aug;14(3):274-8. doi: 10.1007/s10120-011-0038-0. Epub 2011 Apr 2.
In patients with stage II/III gastric cancer, tumors often recur even after curative D2 gastrectomy followed by adjuvant S-1 chemotherapy. The objective of this retrospective study was to clarify the prognostic factors in these patients that might be useful for future patients.
Overall survival (OS) was examined in 82 gastric cancer patients who underwent curative D2 surgery; were diagnosed with stage IIA, IIB, IIIA, IIIB, or IIIC pathologically; and received adjuvant S-1 after surgery between June 2002 and March 2010.
When length of OS was evaluated by the log-rank test, significant differences were observed with regard to macroscopic tumor diameter and the depth of tumor invasion. A macroscopic tumor diameter >70 mm was regarded as a critical point of classification considering survival. Univariate and multivariate Cox's proportional hazard analyses demonstrated that macroscopic tumor diameter was the only significant independent prognosticator. The 5-year survival was 64.9% in patients with a macroscopic tumor diameter <70 mm, and 33.1% in patients with a macroscopic tumor diameter ≥70 mm (P = 0.022).
The macroscopic tumor diameter was the most important prognostic factor for survival in patients with stage II/III gastric cancer who underwent D2 gastrectomy followed by adjuvant S-1 chemotherapy. Prognostic factors can be affected by adjuvant chemotherapy.
在 II/III 期胃癌患者中，即使在接受根治性 D2 胃切除术和辅助 S-1 化疗后，肿瘤仍常常复发。本回顾性研究的目的是明确这些患者的预后因素，以便为未来的患者提供参考。
我们对 82 例于 2002 年 6 月至 2010 年 3 月期间接受根治性 D2 手术、病理诊断为 IIA、IIB、IIIA、IIIB 或 IIIC 期、术后接受辅助 S-1 化疗的胃癌患者的总生存期（OS）进行了评估。
通过对数秩检验评估 OS 时，肿瘤的宏观直径和肿瘤侵犯深度存在显著差异。考虑到生存情况，将宏观肿瘤直径>70mm 作为分类的临界点。单因素和多因素 Cox 比例风险分析表明，宏观肿瘤直径是唯一具有显著意义的独立预后因素。宏观肿瘤直径<70mm 的患者 5 年生存率为 64.9%，而宏观肿瘤直径≥70mm 的患者 5 年生存率为 33.1%（P=0.022）。
对于接受 D2 胃切除术和辅助 S-1 化疗的 II/III 期胃癌患者，宏观肿瘤直径是生存的最重要预后因素。辅助化疗可能会影响预后因素。
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