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日本外科切除胃癌病例的 5 年生存分析:日本胃癌协会全国登记处(2001-2007 年)对超过 10 万名患者的回顾性分析。

Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007).

机构信息

Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan.

出版信息

Gastric Cancer. 2018 Jan;21(1):144-154. doi: 10.1007/s10120-017-0716-7. Epub 2017 Apr 17.

Abstract

BACKGROUND

The aim of this retrospective study was to investigate the tumor characteristics, surgical details, and survival distribution of surgically resected cases of gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association.

METHODS

Data from 118,367 patients with primary gastric carcinoma who underwent resection between 2001 and 2007 were included in the survival analyses. The 5-year survival rates were calculated for various subsets of prognostic factors.

RESULTS

The median age of the patients was 67 years. The proportions of patients with pathological stage (Japanese Gastric Cancer Association) IA, IB, II, IIIA, IIIB, and IV disease were 44.0%, 14.7%, 11.7%, 9.5%, 5.0%, and 12.4% respectively. The death rate within 30 days of operation was 0.5%. The 5-year overall survival rate in the 118,367 patients who were treated by resection was 71.1%. The 5-year overall survival rates of patients with pathological stage IA, IB, II, IIIA, IIIB, and IV disease were 91.5%, 83.6%, 70.6%, 53.6%, 34.8%, and 16.4% respectively. The 5-year disease-specific survival rates in the patients with pT1 (mucosa) disease after D1+ dissection of lymph node station no. 7 (D1 + α), D1+ dissection of lymph node station nos. 7, 8, and 9 (D1+ β), and D2 lymphadenectomy were 99.4%, 99.6%, and 99.1% respectively. The 5-year disease-specific survival rates in the patients with pT1 (submucosa) disease after D1 + α, D1 + β, and D2 lymphadenectomy were 97.3%, 98.1%, and 96.9% respectively.

CONCLUSION

Detailed analyses of the data from more than 100,000 patients show the recent trends of the outcomes of gastric cancer treatment in Japan and provide baseline information for use by medical communities around world.

摘要

背景

本回顾性研究旨在调查日本胃癌协会全国登记处手术切除的胃癌病例的肿瘤特征、手术细节和生存分布。

方法

纳入了 2001 年至 2007 年间接受切除术的 118367 例原发性胃癌患者的数据,用于生存分析。对各种预后因素亚组计算了 5 年生存率。

结果

患者的中位年龄为 67 岁。病理分期(日本胃癌协会)IA、IB、II、IIIA、IIIB 和 IV 期患者的比例分别为 44.0%、14.7%、11.7%、9.5%、5.0%和 12.4%。术后 30 天内死亡率为 0.5%。118367 例接受切除术治疗的患者 5 年总生存率为 71.1%。IA、IB、II、IIIA、IIIB 和 IV 期患者的 5 年总生存率分别为 91.5%、83.6%、70.6%、53.6%、34.8%和 16.4%。pT1(黏膜)疾病患者接受 D1+淋巴结站 7 清扫(D1+α)、D1+淋巴结站 7、8 和 9 清扫(D1+β)和 D2 淋巴结清扫后 5 年疾病特异性生存率分别为 99.4%、99.6%和 99.1%。pT1(黏膜下)疾病患者接受 D1+α、D1+β 和 D2 淋巴结清扫后 5 年疾病特异性生存率分别为 97.3%、98.1%和 96.9%。

结论

对 10 万余例患者数据的详细分析显示了日本胃癌治疗结果的近期趋势,并为全球医疗界提供了基线信息。

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