Kim Woochul, Youn Sangil, Won Yongjoon, Min Sahong, Park Young Suk, Ahn Sang-Hoon, Park Do Joong, Kim Hyung-Ho
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Minim Invasive Surg. 2020 Dec 15;23(4):163-171. doi: 10.7602/jmis.2020.23.4.163.
The purpose of this study was to investigate the clinicopathologic characteristics of young gastric cancer patients and analyze the risk factors for stage underestimation and survival.
Relevant data of 5029 patients who underwent surgery for gastric cancer at Seoul National University Bundang Hospital between 2003 to 2014 were collected. Patients were divided based on age (younger group and older group). Clinical stages were compared to pathologic stages for accuracy, and risk factors for underestimation were analyzed using univariate and multivariate analysis regression. Overall survival and cancer-specific survival were analyzed using the Kaplan-Meier method.
A total of 4396 patients were eligible for inclusion. The younger group was an independent risk factor for nodal metastasis (RR=1.44, 95% CI 1.061.95) and an independent risk factor for clinical N-stage underestimation (RR=1.50, 95% CI=1.141.98). However, there was no significant difference in 5-year cancer-specific survival for both age groups (92.2% vs 90.2%, =0.306).
In conclusion, intra-operative investigation of T-stage with standard operation should be done in young gastric cancer patients as they have a higher incidence of lymph node metastasis, with greater frequency of stage underestimation.
本研究旨在调查青年胃癌患者的临床病理特征，并分析分期低估及生存的危险因素。
收集2003年至2014年在首尔国立大学盆唐医院接受胃癌手术的5029例患者的相关数据。根据年龄将患者分为两组（青年组和老年组）。比较临床分期与病理分期的准确性，并采用单因素和多因素分析回归分析分期低估的危险因素。采用Kaplan-Meier法分析总生存期和癌症特异性生存期。
共有4396例患者符合纳入标准。青年组是淋巴结转移的独立危险因素（RR=1.44，95%CI 1.061.95），也是临床N分期低估的独立危险因素（RR=1.50，95%CI=1.141.98）。然而，两组的5年癌症特异性生存率无显著差异（92.2%对90.2%，P=0.306）。
总之，青年胃癌患者淋巴结转移发生率较高，分期低估频率较高，因此应在标准手术中对其进行T分期的术中探查。
