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术前握力对进展期胃癌胃切除术后长期结局的影响。

The impact of the preoperative hand grip strength on the long-term outcomes after gastrectomy for advanced gastric cancer.

机构信息

Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.

Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.

出版信息

Surg Today. 2021 Jul;51(7):1179-1187. doi: 10.1007/s00595-021-02256-y. Epub 2021 Mar 13.

Abstract

PURPOSE

The correlation of the hand grip strength (HGS) and long-term outcomes after gastrectomy for gastric cancer patients is unknown. This study reveals the impact of the pre-operative HGS on the post-operative survival in gastric cancer patients.

METHODS

This study is a retrospective cohort of consecutive patients who underwent gastrectomy for primary p-T2 (MP) or more advanced gastric cancer from September 2014 to April 2018 with records of pre-operative HGS. The high and low HGS groups were compared by Kaplan-Meier survival analyses for the overall survival (OS), cancer-specific survival (CSS), other-cause survival (OCS), and disease-free survival (DFS).

RESULTS

Of the 96 patients, 35 (36.5%) were in the low HGS group, and 61 (63.5%) were in the high HGS group. The OS was significantly worse in the low HGS group than in the high HGS group (P = 0.013). There was no marked difference in the CSS (P = 0.214) or DFS (P = 0.675) between the groups, but the OCS was worse in the low HGS group than in the high HGS group (P = 0.029). Multivariate analyses of the prognostic factors concluded that a low HGS (P = 0.031) and open surgery (P = 0.011) were significant independent factors.

CONCLUSIONS

A low pre-operative HGS is an independent predictor of a poor prognosis after gastrectomy for patients with advanced gastric cancer and may increase the risk of other causes of death.

摘要

目的

胃癌患者胃切除术后手握力(HGS)与长期预后的相关性尚不清楚。本研究揭示了术前 HGS 对胃癌患者术后生存的影响。

方法

本研究为回顾性队列研究,纳入 2014 年 9 月至 2018 年 4 月期间因原发性 p-T2(MP)或更晚期胃癌接受胃切除术且有术前 HGS 记录的连续患者。通过 Kaplan-Meier 生存分析比较高、低 HGS 组的总生存期(OS)、癌症特异性生存期(CSS)、其他原因生存期(OCS)和无病生存期(DFS)。

结果

96 例患者中,35 例(36.5%)为低 HGS 组,61 例(63.5%)为高 HGS 组。低 HGS 组的 OS 明显差于高 HGS 组(P=0.013)。两组 CSS(P=0.214)或 DFS(P=0.675)无显著差异,但低 HGS 组的 OCS 差于高 HGS 组(P=0.029)。多因素预后因素分析表明,低 HGS(P=0.031)和开放性手术(P=0.011)是独立的显著预后因素。

结论

术前 HGS 低是晚期胃癌患者胃切除术后预后不良的独立预测因素,可能增加其他死亡原因的风险。

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