Feng Fan, Tian Yangzi, Zang Yuan, Sun Li, Hong Liu, Yang Jianjun, Guo Man, Lian Xiao, Fan Daiming, Zhang Hongwei
Division of Digestive Surgery, Xijing Hospital of Digestive Disease, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
Oncotarget. 2017 Apr 25;8(17):28897-28905. doi: 10.18632/oncotarget.15953.
Preoperative pulmonary function assessment is used to select surgical candidates and predict the occurrence of postoperative complications. The present study enrolled 1210 gastric cancer patients (949 males and 261 females). Forced vital capacity (FVC) and maximal voluntary ventilation (MVV) were measured as a percent of predicted values. We then analyzed associations between patient pulmonary function and both prognosis and postoperative complications. Patient 1-, 3- and 5-year overall survival rates were 88.8%, 65.7% and 53.0%, respectively. FVC and MVV optimal cutoff values were 87.0 (P=0.003) and 83.6 (P=0.026), respectively. Low FVC and low MVV were associated with higher rates of postoperative fever (23.8% vs. 13.9%, P<0.001; 17.8% vs. 13.3%, P=0.049, respectively) and poor patient prognosis (5-year overall survival: 43.5% vs. 57.6%, P=0.003; 51.8% vs. 54.3%, P=0.026, respectively). Only low FVC was an independent prognostic predictor for gastric cancer (P=0.012). In subgroup analyses, FVC was not associated with stage I or II gastric cancer patient prognoses (P>0.05), but low FVC was an independent risk factor for poor prognosis in stage III gastric cancer cases (P=0.004). These findings indicate that low FVC is predictive of poorer prognosis and higher risk of postoperative fever in gastric cancer patients.
术前肺功能评估用于筛选手术候选人并预测术后并发症的发生。本研究纳入了1210例胃癌患者（949例男性和261例女性）。测量用力肺活量（FVC）和最大自主通气量（MVV）占预测值的百分比。然后，我们分析了患者肺功能与预后及术后并发症之间的关联。患者1年、3年和5年总生存率分别为88.8%、65.7%和53.0%。FVC和MVV的最佳截断值分别为87.0（P = 0.003）和83.6（P = 0.026）。低FVC和低MVV与术后发热率较高相关（分别为23.8%对13.9%，P < 0.001；17.8%对13.3%，P = 0.049）以及患者预后较差（5年总生存率：分别为43.5%对57.6%，P = 0.003；51.8%对54.3%，P = 0.026）。只有低FVC是胃癌的独立预后预测因素（P = 0.012）。在亚组分析中，FVC与I期或II期胃癌患者的预后无关（P > 0.05），但低FVC是III期胃癌病例预后不良的独立危险因素（P = 0.004）。这些发现表明，低FVC可预测胃癌患者预后较差及术后发热风险较高。
