Zhang Mao-shen, Mao Wei-zheng, Zhou Yan-bing, Li Yang
Department of General Surgery, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.
Zhonghua Zhong Liu Za Zhi. 2012 Mar;34(3):236-9. doi: 10.3760/cma.j.issn.0253-3766.2012.03.017.
To investigate the independent prognostic factors of long-term survival for gastric stump cancer after radical resection.
The clinicopathological and follow-up data of 63 patients with gastric stump cancer undergoing surgical treatment from January 1996 to December 2006 in our hospital were analyzed retrospectively, including age, gender, types of reconstruction, tumor location, histological types, TNM stages, surgical treatment, prognosis and etc. The survival was estimated using Kaplan-Meier method and compared using log-rank test. The effect of independent factors on prognosis was determined by Cox regression multivariate analysis.
Radical resection was performed in 35 patients, including combined multiple organ resection (n=16). Surgery was palliative in 28 patients. All the 63 patients were followed up. The median survival time of these 63 patients was 21 months, and the overall 1-, 3-, 5-year survival rates were 76.2%, 31.7% and 18.8%, respectively. Univariate and multivariate analysis showed that surgical procedure, clinical stage and histological type were independent prognostic factors of gastric stump cancer, while age, gender, type of reconstruction and tumor location were not significantly correlated with prognosis.
Radical resection, clinical stage and histological type are main prognostic factors for gastric stump cancer. Radical resection is an effective way to prolong the postoperative survival time in patients with gastric stump cancer, especially in the early stage.
探讨根治性切除术后残胃癌长期生存的独立预后因素。
回顾性分析1996年1月至2006年12月在我院接受手术治疗的63例残胃癌患者的临床病理及随访资料,包括年龄、性别、重建类型、肿瘤部位、组织学类型、TNM分期、手术治疗、预后等。采用Kaplan-Meier法估计生存率,采用log-rank检验进行比较。通过Cox回归多因素分析确定独立因素对预后的影响。
35例行根治性切除,其中联合多脏器切除16例。28例行姑息性手术。63例均获随访。63例患者的中位生存时间为21个月,1、3、5年总生存率分别为76.2%、31.7%和18.8%。单因素和多因素分析显示,手术方式、临床分期和组织学类型是残胃癌的独立预后因素,而年龄、性别、重建类型和肿瘤部位与预后无明显相关性。
根治性切除、临床分期和组织学类型是残胃癌的主要预后因素。根治性切除是延长残胃癌患者术后生存时间的有效方法,尤其是早期患者。