Deng Jingyu, Liang Han, Zhang Rupeng, Sun Dan, Pan Yi, Zhang Li, Hao Xishan
Department of Gastric Cancer Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
Tumour Biol. 2012 Dec;33(6):2091-8. doi: 10.1007/s13277-012-0468-2. Epub 2012 Aug 7.
Many issues of middle-third gastric cancer need to be address for obtaining preferably clinical treatment. The objective of this retrospective study was to analyze clinicopathologic characteristics and results of surgery for 113 middle-third gastric cancer patients admitted to our hospital. Retrospective cohort analyses of clinicopathologic data and postoperative prognosis of 113 middle-third gastric cancer patients who underwent curative resection between January 1997 and December 2003 were reviewed. Compared with lower-third gastric cancer patients, middle-third gastric cancer patients had significantly lower 5-year survival rate (P < 0.001) and higher recurrence rate (P < 0.001). With the Cox proportional hazards model analysis, the types of gastrectomy (hazard ratio (HR) = 0.495, P = 0.012) and ratio between metastatic and dissected lymph nodes (RML) (HR = 1.681, P < 0.001) were identified as the independent predictors of overall survival (OS) of middle-third gastric cancer patients. Besides, only RML (HR = 3.026, P < 0.001) was an independent predictor of recurrence for middle-third gastric cancer patients after surgery identified using the logistic regression analysis. The prognosis of middle-third gastric cancer was significantly worse than lower-third gastric cancer. RML was a key indicator for OS and recurrence of middle-third gastric cancer.
为了获得更好的临床治疗效果,胃中上部癌的许多问题都需要解决。本回顾性研究的目的是分析我院收治的113例胃中上部癌患者的临床病理特征及手术结果。回顾性队列分析了1997年1月至2003年12月期间接受根治性切除的113例胃中上部癌患者的临床病理数据及术后预后。与胃下部癌患者相比,胃中上部癌患者的5年生存率显著较低(P<0.001),复发率较高(P<0.001)。通过Cox比例风险模型分析,胃切除术类型(风险比(HR)=0.495,P=0.012)和转移淋巴结与清扫淋巴结之比(RML)(HR=1.681,P<0.001)被确定为胃中上部癌患者总生存(OS)的独立预测因素。此外,在逻辑回归分析中,仅RML(HR=3.026,P<0.001)是胃中上部癌患者术后复发的独立预测因素。胃中上部癌的预后明显比胃下部癌差。RML是胃中上部癌OS和复发的关键指标。