Kim J P, Kim Y W, Yang H K, Noh D Y
Department of Surgery, Seoul National University College of Medicine, Korea.
World J Surg. 1994 Nov-Dec;18(6):872-7; discussion 877-8. doi: 10.1007/BF00299091.
Univariate and multivariate analyses of 3926 selected gastric cancer patients collected between 1981 and 1991 were made to confirm several clinicopathologic prognostic factors and to evaluate the effectiveness of postoperative immunochemotherapy with OK-432, 5-FU, and mitomycin C in stage III gastric cancer. Five-year survival rates for each category of prognostic variables were obtained; and in the univariate analysis, most of the factors (including age, depth of invasion, lymph node metastasis, location of primary tumor, histologic differentiation, and gross type except for sex) showed some significance. Multivariate analysis was conducted and verified significant prognostic factors. Depth of invasion and lymph node metastasis were found to be the most powerful factors (p < 0.001); gross type, location, and histologic differentiation were additional significant factors (p < 0.05). For postoperative treatment, immunochemosurgery was most effective in stage III patients (p < 0.05). In conclusion, we may predict a prognosis for gastric cancer more precisely on the basis of these independent prognostic factors, and immunochemosurgery may be a valuable means to treat advanced gastric cancer.
对1981年至1991年间收集的3926例选定胃癌患者进行单因素和多因素分析,以确认几种临床病理预后因素,并评估OK - 432、5 - 氟尿嘧啶和丝裂霉素C术后免疫化疗对III期胃癌的有效性。获得了各类预后变量的五年生存率;在单因素分析中,大多数因素(包括年龄、浸润深度、淋巴结转移、原发肿瘤位置、组织学分化和大体类型,但性别除外)显示出一定的显著性。进行了多因素分析并验证了显著的预后因素。发现浸润深度和淋巴结转移是最有力的因素(p < 0.001);大体类型、位置和组织学分化是另外的显著因素(p < 0.05)。对于术后治疗,免疫化学手术对III期患者最有效(p < 0.05)。总之,我们可以根据这些独立的预后因素更准确地预测胃癌的预后,并且免疫化学手术可能是治疗进展期胃癌的一种有价值的方法。