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[III期胃癌患者的临床病理特征及预后因素]

[Clinicopathological characteristics and prognostic factors in patients with stage III gastric cancer].

作者信息

Xu Yan, Sun Zhe, Wang Zhen-ning, Xu Hui-mian

机构信息

Department of Surgical Oncology, China Medical University, Shenyang, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Feb;15(2):125-8.

Abstract

OBJECTIVE

To investigate the clinicopathological characteristics and prognostic factors of stage III gastric cancer.

METHODS

A retrospectively study of 1007 patients with Stage III gastric cancer in a single institute in China was performed. The patients underwent surgical resection from January 1991 to December 2005. Univariate and multivariate analyses were performed using log-rank test and Cox proportional hazards model to access the prognostic factors in stage III gastric cancer patients who received curative (R0) gastric resection.

RESULTS

The mean age of the 1007 patients was 58.7 years and the male-to-female ratio was 2.6:1.0. There were 242 patients with stage IIIA disease, 403 patients with stage IIIB, and 362 patients with stage IIIC. R0, R1, and R2 resection were performed in 754 patients (74.9%), 56 patients (5.5%), and 197 patients (19.6%), respectively. The 5-year survival rate (37.8%) of patients who received R0 resection was significant higher than that of patients who received R1(21.2%) and R2(8.9%) resection (P<0.05). Multivariate analysis revealed that pN stage, pT stage, and Borrmann type were independent prognostic factors (all P<0.01).

CONCLUSIONS

Stage III gastric cancer patients have certain clinicopathological characteristics and R0 resection should be performed if possible. Lymph node count, depth of tumor invasion, and Borrmann type are independent prognostic factors in stage III gastric cancer patients undergoing R0 resection.

摘要

目的

探讨Ⅲ期胃癌的临床病理特征及预后因素。

方法

对中国一家机构的1007例Ⅲ期胃癌患者进行回顾性研究。这些患者在1991年1月至2005年12月期间接受了手术切除。采用对数秩检验和Cox比例风险模型进行单因素和多因素分析,以评估接受根治性(R0)胃切除的Ⅲ期胃癌患者的预后因素。

结果

1007例患者的平均年龄为58.7岁,男女比例为2.6:1.0。有242例ⅢA期疾病患者,403例ⅢB期患者和362例ⅡIC期患者。754例患者(74.9%)、56例患者(5.5%)和197例患者(19.6%)分别进行了R0、R1和R2切除。接受R0切除的患者的5年生存率(37.8%)显著高于接受R1(21.2%)和R2(8.9%)切除的患者(P<0.05)。多因素分析显示,pN分期、pT分期和Borrmann分型是独立的预后因素(均P<0.01)。

结论

Ⅲ期胃癌患者具有一定的临床病理特征,应尽可能进行R0切除。淋巴结计数、肿瘤浸润深度和Borrmann分型是接受R0切除的Ⅲ期胃癌患者的独立预后因素。

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