Fujita Keizo, Kanda Mitsuro, Ito Seiji, Mochizuki Yoshinari, Teramoto Hitoshi, Ishigure Kiyoshi, Murai Toshifumi, Asada Takahiro, Ishiyama Akiharu, Matsushita Hidenobu, Tanaka Chie, Kobayashi Daisuke, Fujiwara Michitaka, Murotani Kenta, Kodera Yasuhiro
Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan.
Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Gastric Cancer. 2020 Mar;20(1):41-49. doi: 10.5230/jgc.2020.20.e3. Epub 2020 Jan 20.
Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset.
We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014.
Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence.
LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.
病理分期为T1N+或T2 - 3N0的胃癌患者在根治性胃切除术后可能会出现疾病复发。然而，目前的日本胃癌治疗指南并不推荐对此类患者进行术后辅助化疗。本研究旨在使用多机构数据集确定pT1N+或pT2 - 3N0胃癌患者的预后因素。
我们回顾性分析了2010年至2014年间在9家机构接受根治性胃切除术的401例pT1N+或pT2 - 3N0胃癌患者的数据。
在评估的401例患者中，24例（6.0%）出现术后疾病复发。多因素分析显示，年龄≥70岁（风险比[HR]，2.62；95%置信区间[CI]，1.09 - 7.23；P = 0.030）以及淋巴管和/或静脉侵犯（淋巴血管侵犯[LVI]：HR，7.88；95% CI，1.66 - 140.9；P = 0.005）是无复发生存不良的独立预后因素。LVI与初始复发部位之间无显著关联。
LVI是pT1N+或pT2 - 3N0胃癌患者预后不良的一个指标。
