Malik Adnan, Ali Farman, Malik Muhammad Imran, Qureshi Shahbaz
Division of Gastroenterology, Mountain Vista Medical Center, Mesa, AZ, USA.
Corewell Health Dearborn Hospital, Dearborn, MI, USA.
Gastroenterology Res. 2024 Jun;17(3):133-145. doi: 10.14740/gr1715. Epub 2024 Jun 29.
Gastric adenocarcinoma (GAC) is a deadly tumor. Postoperative complications, including infections, worsen its prognosis and may affect overall survival. Little is known about perioperative complications as well as modifiable and non-modifiable risk factors. Early detection and treatment of these risk factors may affect overall survival and mortality.
We extracted GAC patient's data from the Surveillance, Epidemiology, and End Results (SEER) database and analyzed using Pearson's Chi-square, Cox regression, Kaplan-Meier, and binary regression methods in SPSS.
At the time of analysis, 59,580 GAC patients were identified, of which 854 died of infection. Overall, mean survival in months was better for younger patients, age < 50 years vs. ≥ 50 years (60.45 vs. 56.75), and in females vs. males (65.23 vs. 53.24). The multivariate analysis showed that the risk of infectious mortality was higher in patients with age ≥ 50 years (hazard ratio (HR): 3.137; 95% confidence interval (CI): 2.178 - 4.517), not treated with chemotherapy (HR: 1.669; 95% CI: 1.356 - 2.056), or surgery (HR: 1.412; 95% CI:1.132 - 1.761) and unstaged patients (HR: 1.699; 95% CI: 1.278 - 2.258). In contrast, the mortality risk was lower in females (HR: 0.658; 95% CI: 0.561 - 0.773) and married patients (HR: 0.627; 95% CI: 0.506 - 0.778). The probability of infection was higher in older patients (odds ratio (OR) of 2.094 in ≥ 50 years), other races in comparison to Whites and Blacks (OR: 1.226), lesser curvature, not other specified (NOS) as a primary site (OR: 1.325), and patients not receiving chemotherapy (OR: 1.258).
Older, unmarried males with GAC who are not treated with chemotherapy or surgery are at a higher risk for infection-caused mortality and should be given special attention while receiving treatment.
胃腺癌（GAC）是一种致命性肿瘤。术后并发症，包括感染，会恶化其预后并可能影响总生存期。关于围手术期并发症以及可改变和不可改变的风险因素，人们了解甚少。对这些风险因素的早期检测和治疗可能会影响总生存期和死亡率。
我们从监测、流行病学和最终结果（SEER）数据库中提取了GAC患者的数据，并在SPSS中使用Pearson卡方检验、Cox回归、Kaplan-Meier法和二元回归方法进行分析。
在分析时，共识别出59580例GAC患者，其中854例死于感染。总体而言，年龄＜50岁的年轻患者的平均生存期（月）优于年龄≥50岁的患者（60.45对56.75），女性患者优于男性患者（65.23对53.24）。多因素分析显示，年龄≥50岁的患者（风险比（HR）：3.137；95%置信区间（CI）：2.178 - 4.517）、未接受化疗的患者（HR：1.669；95% CI：1.356 - 2.056）、未接受手术的患者（HR：1.412；95% CI：1.132 - 1.761）以及分期不明的患者（HR：1.699；95% CI：1.278 - 2.258）感染导致死亡的风险更高。相比之下，女性患者（HR：0.658；95% CI：0.561 - 0.773）和已婚患者（HR：0.627；95% CI：0.506 - 0.778）的死亡风险较低。年龄较大的患者（≥50岁的优势比（OR）为2.094）感染的可能性更高，与白人和黑人相比其他种族的患者（OR：1.226）、以胃小弯而非其他未指定部位（NOS）作为原发部位的患者（OR：1.325）以及未接受化疗的患者（OR：1.258）感染的可能性更高。
未接受化疗或手术治疗的老年未婚男性GAC患者因感染导致死亡的风险更高，在接受治疗时应给予特别关注。
