Yamashita Keishi, Sakuramoto Shinichi, Katada Natsuya, Kikuchi Shiro, Watanabe Masahiko
Hepatogastroenterology. 2014 Mar-Apr;61(130):512-7.
BACKGROUND/AIM: Macroscopic features and age may be important prognostic factors that discriminate survival among clinical conditions requiring different therapeutic strategies of advanced gastric cancer (AGC), and this study aimed to identify their clinical relevance.
A total of 232 AGC patients who had Surgical T2b or beyond was enrolled to identify clinical indicators, including macroscopic features in combination with age.
Macroscopic features were divided into 3 categories (types I/II/V, III, and IV), which included stage IV in 24%, 53%, and 72% (P < 0.0001), respectively. Macroscopic features (P < 0.0001), histological features (P = 0.025), and pathological infiltration type (P = 0.0003) were all univariate prognostic factors, as well as stage (P < 0.0001) and age (P = 0.009). However, the multivariate proportional hazards model found that macroscopic features (P = 0.0013) and age (P = 0.0091) were the only factors independent of stage (P <0.0001). Both factors clearly classified the patients into 4 groups (young type 1/II/V (group 1), elderly type I/II/V (group 2), type III and young type IV (group 3), and elderly type IV (group 4) with different prognoses.
Macroscopic features and age were simple indicators of prognosis in AGC. Both factors may have great potential to develop prognostic categories that effectively classify AGC into categories requiring different therapeutic strategies.
背景/目的：宏观特征和年龄可能是区分需要不同治疗策略的晚期胃癌（AGC）临床状况下生存情况的重要预后因素，本研究旨在确定它们的临床相关性。
共纳入232例手术T2b及以上的AGC患者，以确定临床指标，包括宏观特征与年龄的组合。
宏观特征分为3类（I/II/V型、III型和IV型），IV期分别占24%、53%和72%（P<0.0001）。宏观特征（P<0.0001）、组织学特征（P=0.025）和病理浸润类型（P=0.0003）均为单因素预后因素，分期（P<0.0001）和年龄（P=0.009）也是。然而，多变量比例风险模型发现，宏观特征（P=0.0013）和年龄（P=0.0091）是独立于分期（P<0.0001）的唯一因素。这两个因素都将患者明确分为4组（年轻的I/II/V型（第1组）、老年的I/II/V型（第2组）、III型和年轻的IV型（第3组）以及老年的IV型（第4组）），预后不同。
宏观特征和年龄是AGC预后的简单指标。这两个因素都可能有很大潜力开发预后分类，有效地将AGC分为需要不同治疗策略的类别。
