Qi L K, Yuan X H
Department of Abdominal Surgery, National Cancer Center/Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2016 Aug;38(8):620-3. doi: 10.3760/cma.j.issn.0253-3766.2016.08.010.
To investigate the correlation between clinicopathological features and prognosis in patients with synchronous multiple gastric carcinoma (SMGC).
The clinicopathological data of 142 patients who underwent gastrectomy for SMGC from January 2000 to May 2014 at the Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed, mainly including epidemiological statistics (age, gender), surgery-related information (surgical mode, operation time, intraoperative blood loss), carcinoma-related data (quantity, location, degree of differentiation, T stage, maximum tumor diameter, vascular tumor thrombus, cutting edge, postoperative adjuvant chemotherapy), and lymph node status (number of lymph nodes dissected, lymph node metastasis). The survival analysis was performed using the Kaplan-Meier and log-rank test and multi-factor analysis with the Cox proportional hazard regression model.
A total of 142 SMGC patients were included in the study, 118 men and 24 women, with an average age of 66.9 (range 32-90) years old at the time of diagnosis. There were a total of 294 lesions in 142 patients, including 136 with 2 primary gastric tumors and other 6 with 3 or more. Among these lesions, 104, 83, and 107 carcinomas were located in the proximal stomach, gastric body and distal stomach, respectively. The average diameter of the main tumors was 3.65 (0.8-15) cm, while that of the accessory ones was 3.31 (0.5-12) cm. The postoperative pathology showed that there were 97 T1, 51 T2, 62 T3, and 84 T4 lesions. Among the 142 patients, 90 (63.4%) had lymph node metastasis, and the average number of dissected lymph nodes was 25.5 (13-66). The postoperative 3-year and 5-year survival rates of the 142 patients were 73.5% and 52.2%, respectively. The univariate analysis revealed that both the main tumor T stage and TNM stage are related to the postoperative survival of SMGC patients (P<0.05 for both). The multivariate analysis showed that main tumor T stage and TNM stage are independent factors affecting prognosis of SMGC patients (average P<0.05 for both).
SMGC is a special type of gastric cancer. The main treatment is radical gastrectomy. The Main tumor T stage and TNM stage are associated with the prognosis of SMGC patients.
探讨同步性多原发性胃癌(SMGC)患者临床病理特征与预后的相关性。
回顾性分析2000年1月至2014年5月在中国医学科学院肿瘤医院腹部外科接受胃切除术的142例SMGC患者的临床病理资料,主要包括流行病学统计(年龄、性别)、手术相关信息(手术方式、手术时间、术中出血量)、肿瘤相关数据(数量、位置、分化程度、T分期、最大肿瘤直径、血管内肿瘤血栓、切缘、术后辅助化疗)以及淋巴结状况(清扫淋巴结数量、淋巴结转移情况)。采用Kaplan-Meier法和log-rank检验进行生存分析,并使用Cox比例风险回归模型进行多因素分析。
本研究共纳入142例SMGC患者,其中男性118例,女性24例,诊断时平均年龄为66.9岁(范围32 - 90岁)。142例患者共有294个病灶,其中136例有2个原发性胃肿瘤,6例有3个及以上。在这些病灶中,分别有104、83和107个癌灶位于胃近端、胃体和胃远端。主要肿瘤的平均直径为3.65(0.8 - 15)cm,次要肿瘤的平均直径为3.31(0.5 - 12)cm。术后病理显示,T1期病变97例,T2期51例,T3期62例,T4期84例。142例患者中,90例(63.4%)有淋巴结转移,平均清扫淋巴结数为25.5个(13 - 66个)。142例患者术后3年和5年生存率分别为73.5%和52.2%。单因素分析显示,主要肿瘤T分期和TNM分期均与SMGC患者术后生存相关(两者P均<0.05)。多因素分析表明,主要肿瘤T分期和TNM分期是影响SMGC患者预后的独立因素(两者平均P<0.05)。
SMGC是一种特殊类型的胃癌。主要治疗方法是根治性胃切除术。主要肿瘤T分期和TNM分期与SMGC患者的预后相关。