Arveux P, Piard F, Bedenne L, Boutron M C, Renard P, Faivre J, Klepping C
Registre des tumeurs digestives (équipe associée INSERM-DGS), Faculté de médicine, Dijon, France.
Bull Cancer. 1990;77(8):769-79.
The present study on treatment and prognosis of gastric cancers is based on the data of the digestive tract cancer registry set up for the French department of Côte-d'Or. During the 1976-1985 period, 784 cases of gastric cancer were diagnosed. Resection for cure was performed in 41.3% of gastric cancers and that proportion remained the same during the course of the study period. Operative mortality was 18.5% after resection for cure and 26.7% after palliative surgery. The overall survival rate was 31.7% at 1 year, 17.0% at 3 years, and 13.0% at 5 years. Ten different criteria (personal data, histologic and therapeutic parameters) were studied in relation to survival. With the univariate analysis, the survival rates were related to age, duration of the symptoms, history of previous gastric ulcer, tumour location, stage of diagnosis and treatment. Only 4 aspects were of good prognosis according to the multivariate analysis (Cox model): extension limited to the gastric wall, resection for cure, duration of the symptoms and location to the antrum or the angulus. These results underline the fact that the prognosis of gastric cancer in a well-defined population remains poor. Because of its severity, gastric cancer still represents a major cancer problem.
本项关于胃癌治疗及预后的研究基于为法国科多尔省建立的消化道癌症登记数据。在1976 - 1985年期间,共诊断出784例胃癌病例。41.3%的胃癌患者接受了根治性切除,且该比例在研究期间保持不变。根治性切除术后的手术死亡率为18.5%,姑息性手术后为26.7%。总体生存率1年时为31.7%,3年时为17.0%,5年时为13.0%。研究了与生存相关的10种不同标准(个人数据、组织学和治疗参数)。单因素分析显示,生存率与年龄、症状持续时间、既往胃溃疡病史、肿瘤位置、诊断和治疗阶段有关。多因素分析(Cox模型)显示,只有4个方面预后良好:病变局限于胃壁、根治性切除、症状持续时间以及位于胃窦或胃角。这些结果强调了这样一个事实,即在明确界定的人群中,胃癌的预后仍然很差。由于其严重性,胃癌仍然是一个主要的癌症问题。