Wu C W, Hsieh M C, Lo S S, Tsay S H, Li A F, Lui W Y, P'eng F K
Department of Surgery, Veterans General Hospital-Taipei, Taiwan.
Dig Dis Sci. 1997 Jun;42(6):1265-9. doi: 10.1023/a:1018814426278.
This study aims to determine prognostic indicators among patient-, tumor-, and treatment-related factors of gastric cancer patients. A total of 510 patients who underwent curative gastric resection were studied. Univariate analysis of patient-related factors showed a significantly lower survival in patients with a history of obstruction, hypoalbuminemia, and anemia. Tumor-related factors including gross appearance, location, and size of tumor; depth of cancer invasion; level, number, and frequency of lymph node metastasis; stromal reaction and tumor growth pattern; and histological classification all significantly affected survival. Surgical treatment related factors such as total or distal subtotal gastrectomy, extent of lymphadenectomy, and combined resection of adjacent organ(s) showed a statistically significant adverse influence on survival. Multivariate analysis identified only four tumor-related factors-number of metastatic lymph nodes, depth of cancer invasion, stromal reaction, and gross appearance of the tumor-as independently affecting survival. These findings suggest that only four tumor-related factors were prognostic indicators in patients with gastric cancer.
本研究旨在确定胃癌患者中与患者、肿瘤及治疗相关因素的预后指标。共研究了510例行根治性胃切除术的患者。对与患者相关因素的单因素分析显示，有梗阻史、低白蛋白血症和贫血的患者生存率显著较低。肿瘤相关因素，包括肿瘤的大体外观、位置、大小；癌症浸润深度；淋巴结转移的级别、数量和频率；间质反应和肿瘤生长模式；以及组织学分类，均对生存率有显著影响。手术治疗相关因素，如全胃或远端次全胃切除术、淋巴结清扫范围以及相邻器官联合切除，对生存率有统计学上的显著不利影响。多因素分析仅确定了四个与肿瘤相关的因素——转移淋巴结数量、癌症浸润深度、间质反应和肿瘤大体外观——为独立影响生存率的因素。这些发现表明，在胃癌患者中，只有四个与肿瘤相关的因素是预后指标。
