Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
Surg Today. 2021 Jul;51(7):1179-1187. doi: 10.1007/s00595-021-02256-y. Epub 2021 Mar 13.
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.
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).
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.
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.
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。
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)。
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。
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。