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胃癌:影响生存的因素

Gastric cancer: factors affecting survival.

作者信息

Orman Suleyman, Cayci Haci Murat

机构信息

a Department of General Surgery, Göztepe Teaching and Research Hospital , University of İstanbul Medeniyet , İstanbul , Turkey.

b Department of General Surgery , Bursa Yuksek Ihtisas Teaching and Research Hospital, University of Medical Sciences , Bursa , Turkey.

出版信息

Acta Chir Belg. 2019 Feb;119(1):24-30. doi: 10.1080/00015458.2018.1453437. Epub 2018 Mar 21.

Abstract

BACKGROUND AND AIM

The present multicenter, retrospective study aimed at determining the factors affecting survival in patients who were operated on due to gastric cancer (GC).

PATIENTS AND METHODS

The data of 234 patients, who underwent elective surgery due to GC were retrospectively analyzed. The demographic characteristics, tumor localization and diameter, type of resection and lymph node dissection, experience of the operating surgeon (senior or junior), tumor grade, pT stage, number of lymph nodes harvested, number of lymph nodes with and without metastasis, tumor stage and survival data were recorded.

RESULTS

Survival was better a tumor diameter <4 cm, lower localization, experience of the operating surgeon (senior), without metastatic lymph nodes, tumor grade and decreased invasion depth (p < .05). There was no statistically significant difference between D1 LND and D2 LND with respect to survival (p = .793). Mortality was higher and survival was lower in patients with metastatic lymph nodes (p = .001). A number of harvested lymph nodes of 16 or more increased mortality (p = .003). Also, as disease stage increased, there was a decrease in survival and increase in mortality rates (p = .001).

CONCLUSIONS

Survival outcomes in resectable GCs are affected by the experience of the surgeon and patient-related factors at the time of surgery, including tumor size, T stage, and presence of metastatic lymph nodes.

摘要

背景与目的

本多中心回顾性研究旨在确定因胃癌(GC)接受手术患者的生存影响因素。

患者与方法

对234例因GC接受择期手术的患者数据进行回顾性分析。记录人口统计学特征、肿瘤定位与直径、切除类型与淋巴结清扫情况、手术医生经验(资深或初级)、肿瘤分级(pT分期)、清扫淋巴结数量、有或无转移的淋巴结数量、肿瘤分期及生存数据。

结果

肿瘤直径<4 cm、较低位置、手术医生经验(资深)、无转移淋巴结、肿瘤分级及侵袭深度降低时,生存率更高(p<0.05)。D1淋巴结清扫与D2淋巴结清扫在生存率方面无统计学显著差异(p = 0.793)。有转移淋巴结的患者死亡率更高,生存率更低(p = 0.001)。清扫16个或更多淋巴结会增加死亡率(p = 0.003)。此外,随着疾病分期增加,生存率降低,死亡率升高(p = 0.001)。

结论

可切除GC的生存结果受手术时外科医生经验及患者相关因素影响,包括肿瘤大小、T分期及转移淋巴结的存在情况。

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