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老年胃癌患者胃切除术的预后因素

Prognostic factors for gastrectomy in elderly patients with gastric cancer.

作者信息

Ueno Daisuke, Matsumoto Hideo, Kubota Hisako, Higashida Masaharu, Akiyama Takashi, Shiotani Akiko, Hirai Toshihiro

机构信息

Department of Digestive Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.

Department of Pathology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.

出版信息

World J Surg Oncol. 2017 Mar 11;15(1):59. doi: 10.1186/s12957-017-1131-6.

Abstract

BACKGROUND

The aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer.

METHODS

The medical records of 366 patients with gastric cancer who underwent surgical resection at our hospital between January 2007 and December 2014 were retrospectively reviewed. Of the 366 patients, 117 were aged 75 years or older and 249 were aged 74 years or younger. All factors that were identified as significant using univariate analysis were included in the multivariate analysis.

RESULTS

The median follow-up duration was 52.9 months (range, 1.0-117.5 months). We found that in patients aged 75 years or older, postoperative complications and the extent of cancer were independent prognostic factors of overall survival and disease-free survival. In contrast, in patients aged 74 years or younger, only the lymph node status and postoperative chemotherapy were independent prognostic factors for overall survival and disease-free survival, respectively.

CONCLUSIONS

Pathological outcomes and postoperative complications are important prognostic factors for survival in patients aged 75 years or older with gastric cancer, whereas pathological outcomes and postoperative chemotherapy are important prognostic factors for survival in patients aged 74 years or younger. Because the prevention of postoperative complications may contribute to improvements in the prognosis of elderly patients with gastric cancer, we suggest that it is necessary to consider limited surgery instead of radical surgery, depending on the patient's general condition and co-morbidities.

摘要

背景

本研究的目的是调查接受胃癌胃切除术患者的年龄特异性预后因素。

方法

回顾性分析了2007年1月至2014年12月在我院接受手术切除的366例胃癌患者的病历。在这366例患者中,117例年龄在75岁及以上,249例年龄在74岁及以下。单因素分析中被确定为有意义的所有因素都纳入了多因素分析。

结果

中位随访时间为52.9个月(范围1.0 - 117.5个月)。我们发现,在75岁及以上的患者中,术后并发症和癌症范围是总生存和无病生存的独立预后因素。相比之下,在74岁及以下的患者中,仅淋巴结状态和术后化疗分别是总生存和无病生存的独立预后因素。

结论

病理结果和术后并发症是75岁及以上胃癌患者生存的重要预后因素,而病理结果和术后化疗是74岁及以下患者生存的重要预后因素。由于预防术后并发症可能有助于改善老年胃癌患者的预后,我们建议有必要根据患者的一般状况和合并症考虑进行有限手术而非根治性手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22f3/5346248/b44019d98794/12957_2017_1131_Fig1_HTML.jpg

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