日本 pT1N+或 T2-3N0 胃癌患者生存的预后因素。

Prognostic factors for survival in patients with pT1 N+ or T2-3 N0 gastric cancer in Japan.

机构信息

Division of Gastric Surgery, Shizuoka Cancer Centre, Shizuoka, Japan.

Department of Gastroenterological Surgery, Aichi Cancer Centre Hospital, Aichi, Japan.

出版信息

Br J Surg. 2017 Jun;104(7):885-890. doi: 10.1002/bjs.10509. Epub 2017 Feb 27.

DOI:10.1002/bjs.10509

PMID:28240355

Abstract

BACKGROUND

The outcome for pT1 N+ or pT2-3 N0 gastric cancer is favourable, but some patients suffer from recurrent disease. The aim of this study was to identify prognostic factors in patients with pT1 N+ or pT2-3 N0 gastric cancer.

METHODS

This was a multicentre, retrospective cohort study. All patients with pT1 N+ or pT2-3 N0 gastric cancer who underwent curative gastrectomy at five high-volume, specialized cancer centres in Japan between 2000 and 2008 were included. Demographic, clinical, surgical and pathological data were collected. Independent prognostic factors were identified using a Cox proportional hazards regression model.

RESULTS

Some 1442 patients were included. The 5-year overall survival rate for patients with pT1 N+ or pT2-3 N0 gastric cancer was 92·0 per cent. Multivariable analysis for overall survival identified age (hazard ratio (HR) 2·67, 95 per cent c.i. 2·09 to 3·43), sex (HR 0·57, 0·39 to 0·83) and clinical tumour depth (cT) (HR 1·45, 1·06 to 1·98) as independent prognostic factors.

CONCLUSION

Survival of patients with pT1 N+ or pT2-3 N0 gastric cancer is good. Age 65 years or above, male sex and cT2-4 category are associated with worse overall survival.

摘要

背景

pT1N+或 pT2-3N0 胃癌的预后良好，但部分患者会出现疾病复发。本研究旨在确定 pT1N+或 pT2-3N0 胃癌患者的预后因素。

方法

这是一项多中心、回顾性队列研究。纳入 2000 年至 2008 年期间在日本五家高容量专业癌症中心接受根治性胃切除术的所有 pT1N+或 pT2-3N0 胃癌患者。收集人口统计学、临床、手术和病理数据。使用 Cox 比例风险回归模型确定独立预后因素。

结果

共纳入 1442 例患者。pT1N+或 pT2-3N0 胃癌患者的 5 年总生存率为 92.0%。多变量分析显示，年龄（风险比（HR）2.67，95%置信区间（CI）2.09 至 3.43）、性别（HR 0.57，0.39 至 0.83）和临床肿瘤深度（cT）（HR 1.45，1.06 至 1.98）是独立的预后因素。