Zheng Dingcheng, Chen Bangsheng, Shen Zefeng, Gu Lihu, Wang Xianfa, Ma Xueqiang, Chen Ping, Mao Feiyan, Wang Zhiyan
Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, Zhejiang, China.
Open Med (Wars). 2020 Aug 3;15(1):754-762. doi: 10.1515/med-2020-0164. eCollection 2020.
The purpose of this research is to investigate the prognostic factors of patients with stage I gastric cancer (GC) and to determine whether adjuvant chemotherapy improves the prognosis for high-risk patients.
We performed a retrospective analysis at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and HwaMei Hospital, University of Chinese Academy of Sciences from January 2001 to December 2015. Cox regression and Kaplan-Meier were used to evaluate the relationship between the patients' clinicopathologic characteristics and prognosis.
A total of 1,550 patients were eligible for the study. The 5-year disease-free survival (DFS) rate of all enrolled patients was 96.5%. The pT and pN stages were significantly associated with the prognosis. The 5-year DFS rates of the three subgroups (T1N0, T2N0, and T1N1) were 97.8%, 95.7%, and 90.5%, respectively ( < 0.001). In the T1N1 subgroup, patients not undergoing chemotherapy showed a lower 5-year DFS rate compared to those undergoing chemotherapy, although the difference was not statistically significant.
Both the pT and pN stages were closely associated with the prognosis of patients with stage I GC. We also found that the danger coefficient of the pN stage was higher than that of the pT stage, and that postoperative adjuvant chemotherapy might be a reasonable approach to improve outcomes of high-risk patients, particularly in the T1N1 group.
本研究旨在探讨Ⅰ期胃癌（GC）患者的预后因素，并确定辅助化疗是否能改善高危患者的预后。
我们于2001年1月至2015年12月在浙江大学医学院附属邵逸夫医院和中国科学院大学附属华美医院进行了一项回顾性分析。采用Cox回归和Kaplan-Meier法评估患者临床病理特征与预后之间的关系。
共有1550例患者符合研究条件。所有入组患者的5年无病生存率（DFS）为96.5%。pT和pN分期与预后显著相关。三个亚组（T1N0、T2N0和T1N1）的5年DFS率分别为97.8%、95.7%和90.5%（<0.001）。在T1N1亚组中，未接受化疗的患者5年DFS率低于接受化疗的患者，尽管差异无统计学意义。
pT和pN分期均与Ⅰ期GC患者的预后密切相关。我们还发现pN分期的危险系数高于pT分期，术后辅助化疗可能是改善高危患者预后的合理方法，尤其是在T1N1组。
