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淋巴结阴性胃癌中肿瘤沉积物的预后价值:一项倾向评分匹配研究。

Prognostic value of tumor deposits in lymph node-negative gastric cancer: A propensity score matching study.

作者信息

Xu Ran, Zhang Yisheng, Zhao Jun, Chen Ke, Wang Zhengguang

机构信息

Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Department of General Surgery, The Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.

Department of General Surgery, The Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.

出版信息

Eur J Surg Oncol. 2023 Apr;49(4):845-852. doi: 10.1016/j.ejso.2022.12.004. Epub 2022 Dec 14.

Abstract

BACKGROUND

The purpose of this study was to assess the prognostic value of TD in lymph node-negative GC.

METHODS

A retrospective study was conducted to collect the clinicopathological data from 1224 patients with lymph node-negative GC. According to their TD status, patients were categorized into TD-positive and TD-negative groups. Patients in both groups underwent a 1:1 propensity score matching analysis. Survival analysis was performed by the Kaplan-Meier method, and the differences between survival curves were measured by log-rank test. The cox proportional hazards model was used for univariate and multivariate analyses.

RESULTS

The TD-negative group had higher 5-year overall survival(OS) rate than TD-positive group(69.4%VS.36.4%,P < 0.05). Further subgroup analysis indicated that patients in the TD-negative group had higher 5-year OS rates than those in the TD-positive group in the T1-2, T3, and T4 subgroups(all with P < 0.05).The OS rates were decreased with the increase of the number of TD.The univariate Cox regression analysis demonstrated that tumor location in antrum, distal gastrectomy, perineural invasion, T4-stage,lymphovascular invasion and the number of TD were all associated with prognosis in patients undergoing curative gastric resection (P < 0.05).The multivariable analysis revealed that the number of TD, perineural invasion, lymphovascular invasion and T4 stage were independently associated with OS.

CONCLUSION

In lymph node-negative GC, TD is an independent risk factor for prognosis, regardless of T-stage, and patients with ≥3 TD have a worse prognosis.

摘要

背景

本研究旨在评估肿瘤芽生(TD)在淋巴结阴性胃癌(GC)中的预后价值。

方法

进行一项回顾性研究,收集1224例淋巴结阴性GC患者的临床病理数据。根据TD状态,将患者分为TD阳性组和TD阴性组。两组患者进行1:1倾向评分匹配分析。采用Kaplan-Meier法进行生存分析,通过对数秩检验测量生存曲线之间的差异。使用Cox比例风险模型进行单因素和多因素分析。

结果

TD阴性组的5年总生存率(OS)高于TD阳性组(69.4%对36.4%,P<0.05)。进一步亚组分析表明,在T1-2、T3和T4亚组中,TD阴性组患者的5年OS率高于TD阳性组患者(均P<0.05)。OS率随着TD数量的增加而降低。单因素Cox回归分析表明,胃窦部肿瘤位置、远端胃切除术、神经周围侵犯、T4期、淋巴管侵犯和TD数量均与接受根治性胃切除术患者的预后相关(P<0.05)。多因素分析显示,TD数量、神经周围侵犯、淋巴管侵犯和T4期与OS独立相关。

结论

在淋巴结阴性GC中,无论T分期如何,TD都是预后的独立危险因素,TD≥3的患者预后较差。

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