Shanxi Medical University, Second Department of General Surgery, Shanxi Cancer Hospital, Taiyuan, Shanxi, People's Republic of China.
Shanxi Medical University, Department of Hepatobiliary Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, People's Republic of China.
Medicine (Baltimore). 2022 Feb 4;101(5):e28620. doi: 10.1097/MD.0000000000028620.
We retrospectively reviewed the medical records of patients with pathologically confirmed gastric cancer/adenocarcinoma who underwent curative surgical resection follow-up within 3 years at Shanxi cancer hospital between 2002 and 2020. The clinicopathologic parameters explored included gender, age at surgery, vascular invasion, neural invasion, Tumor infiltration depth (T stage), N stage, TNM stage, chemotherapy, Lauren classification, maximum diameter of tumor, type of gastrectomy, tumor location and survival data.With a median follow-up of 29 months (range 0-36 months), the ratio of patients with recurrence was 26.80% (n = 226) and the death rate of patients was 45.31% (n = 382) in this period. According to the results of univariate analysis, gender (P = .014), age at surgery (P = .010), vascular invasion (P = .000), neural invasion (P = .000), T stage (P = .000), N stage (P = .000), TNM stage (P = .000), chemotherapy cycle (P = .000), lauren classification (P = .000), maximum diameter of tumor (P = .000), type of gastrectomy (P = .000) were independent risk factors of recurrence of follow-up within 3 years. From the multivariate analysis by logistic regression showed that TNM Stage (P = .002), chemotherapy cycle (P = .000) were risk factors of recurrence of follow-up within 3 years. Univariate analysis of survival by Kaplan-Meier showed that gender (P = .038), vascular invasion (P = .000), neural invasion (P = .000), maximum diameter of tumor (P = .000), Lauren classification (P = .000), T stage (P = .000), N stage (P = .000), TNM Stage (P = .000) and type of gastrectomy (P = .000) were key factors linked to overall survival of follow-up within 3 years. The results of the multivariate analysis by Cox regression were clearly presented that T Stage (P = .000), TNM stage (P = .001), maximum diameter of tumor (P = .001) were key factors of overall survival of follow-up within 3 years.TNM Stage, chemotherapy cycle were closely related to recurrence and of follow-up within 3 years. More than 9 cycles of chemotherapy was able to reduce the probability of recurrence. T Stage, TNM stage, maximum diameter of tumor were independent factors associated with overall survival of gastric cancer of follow-up within 3 years. For maximum diameter of tumor, the probability of death of more than 6 cm was 1.317 times less than 6 cm within 3 years of follow-up.
我们回顾性分析了 2002 年至 2020 年间在山西肿瘤医院接受根治性手术切除并在 3 年内随访的病理证实为胃癌/腺癌患者的病历。探索的临床病理参数包括性别、手术时年龄、血管侵犯、神经侵犯、肿瘤浸润深度(T 分期)、N 分期、TNM 分期、化疗、Lauren 分类、肿瘤最大直径、胃切除术类型、肿瘤位置和生存数据。中位随访时间为 29 个月(0-36 个月),在此期间,复发患者的比例为 26.80%(n=226),死亡患者的比例为 45.31%(n=382)。根据单因素分析结果,性别(P=0.014)、手术时年龄(P=0.010)、血管侵犯(P=0.000)、神经侵犯(P=0.000)、T 分期(P=0.000)、N 分期(P=0.000)、TNM 分期(P=0.000)、化疗周期(P=0.000)、Lauren 分类(P=0.000)、肿瘤最大直径(P=0.000)、胃切除术类型(P=0.000)是 3 年内随访复发的独立危险因素。多因素 logistic 回归分析显示,TNM 分期(P=0.002)、化疗周期(P=0.000)是 3 年内随访复发的危险因素。Kaplan-Meier 法单因素生存分析显示,性别(P=0.038)、血管侵犯(P=0.000)、神经侵犯(P=0.000)、肿瘤最大直径(P=0.000)、Lauren 分类(P=0.000)、T 分期(P=0.000)、N 分期(P=0.000)、TNM 分期(P=0.000)和胃切除术类型(P=0.000)是与 3 年内总生存相关的关键因素。Cox 回归多因素分析结果明确显示 T 分期(P=0.000)、TNM 分期(P=0.001)、肿瘤最大直径(P=0.001)是 3 年内总生存的关键因素。TNM 分期、化疗周期与 3 年内复发和随访密切相关。超过 9 个化疗周期可降低复发概率。T 分期、TNM 分期、肿瘤最大直径是与 3 年内胃癌随访总生存相关的独立因素。对于肿瘤最大直径,3 年内肿瘤最大直径超过 6cm 的死亡概率是 6cm 以下的 1.317 倍。