第七版TNM分期是接受有限淋巴结清扫术的胃癌患者总生存预测中最具影响力的变量。

N stages of the seventh edition of TNM Classification are the most intensive variables for predictions of the overall survival of gastric cancer patients who underwent limited lymphadenectomy.

作者信息

Deng Jingyu, Zhang Rupeng, Pan Yuan, Wang Baogui, Wu Liangliang, Hao Xishan, Liang Han

机构信息

Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Hospital and City Key Laboratory of Tianjin Cancer Center, Tianjin, China.

出版信息

Tumour Biol. 2014 Apr;35(4):3269-81. doi: 10.1007/s13277-013-1428-1. Epub 2013 Nov 29.

Abstract

The objective of this study was to explore the prognostic prediction rationality of the seventh edition N stage for gastric cancer (GC) patients who underwent the limited lymphadenectomy. Clinicopathological data of 769 GC patients who underwent the curative resection between 1997 and 2006 were analyzed for demonstration that the seventh edition N stage had the significant superiorities of prognostic prediction to the patients who underwent the limited lymphadenectomy. Although the extent of lymphadenectomy was associated with the overall survival (OS) of gastric cancer (GC) patients, the N stages of the seventh edition of the TNM Classification were identified as the most intensively independent predictors of GC prognosis. Using stratum analysis, the 5-year survival rate of patients who underwent limited lymphadenectomy was observed to be significantly different from that of patients who underwent extended lymphadenectomy, regardless of the extent of lymph node metastasis. Multinomial logistic regression analysis revealed that combining the extents of lymph node metastasis and lymphadenectomy could improve the prediction accuracy of patient survival status. Case control analysis showed that regardless of the extent of lymphadenectomy, the seventh edition N stages featured significant superiority for OS evaluation of GC patients. The seventh edition N stage had the prediction rationality for the OS of GC patients who underwent the limited lymphadenectomy.

摘要

本研究的目的是探讨第七版N分期对接受有限淋巴结清扫术的胃癌(GC)患者预后预测的合理性。分析了1997年至2006年间接受根治性切除术的769例GC患者的临床病理数据,以证明第七版N分期对接受有限淋巴结清扫术的患者在预后预测方面具有显著优势。尽管淋巴结清扫范围与胃癌(GC)患者的总生存期(OS)相关,但TNM分类第七版的N分期被确定为GC预后最有力的独立预测因素。采用分层分析,观察到无论淋巴结转移程度如何,接受有限淋巴结清扫术的患者的5年生存率与接受扩大淋巴结清扫术的患者的5年生存率有显著差异。多项逻辑回归分析显示,结合淋巴结转移程度和淋巴结清扫范围可提高患者生存状态的预测准确性。病例对照分析表明,无论淋巴结清扫范围如何,第七版N分期在GC患者的OS评估方面具有显著优势。第七版N分期对接受有限淋巴结清扫术的GC患者的OS具有预测合理性。

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