The clinicopathological data of 120 patients with advanced gastric cancer were analyzed retrospectively, and clinical and pathological data were collected. Tumor tissue staging and grading were re-evaluated, and 5-year overall survival was followed up. The classified data were described by percentages, and the continuous data were described by standard deviations or medians. Univariate analysis was performed using the χ2 test or rank-sum test, followed by Kaplan-Meier survival analysis to calculate the median survival time and 5-year cumulative survival. A multivariate Cox regression model was used to evaluate the independent risk factors affecting survival. The test level was α = 0.05.
Patients were followed up for 0 to 60 months, the 5-year overall survival rate was 36.2%, and the median survival time was 53.0 ± 1.461 months. K-M and log-rank test results revealed that tumor location, degree of differentiation, depth of invasion, regional lymph node involvement, and postoperative tumor stage were correlated with a decreased 5-year survival rate (P < 0.05). A multivariate Cox risk regression model was used to analyze the degree of histological differentiation (HR = 1.441; 95% CI = 1.049-1.979; P = 0.024), regional lymph node (HR = 1.626; 95% CI = 1.160-2.279; P = 0.005), and pTNM stage (HR = 2.266; 95% CI = 1.335-3.847; P = 0.002), which are independent risk factors for poor survival. Tumor location (P = 0.191), invasion depth (P = 0.579) and tumor size (P = 0.324) were not found to be independent risk factors.
The degree of tumor differentiation, regional lymph node metastasis and postoperative pathological stage were found to be independent risk factors for 5-year overall survival in patients with advanced gastric cancer. Standardized and reasonable lymph node dissection and accurate postoperative pathological staging were very important.
方法:对120例进展期胃癌患者的临床病理资料进行回顾性分析。收集临床和病理资料。重新评估肿瘤组织分期和分级,随访5年总生存率。分类数据以百分比表示,连续数据用标准差或中位数描述。单变量分析采用χ2检验或秩和检验,然后进行Kaplan-Meier生存分析,计算中位生存时间和5年累积生存时间.采用多因素Cox回归模型评价影响生存的独立危险因素。测试水平为α=0.05。
结果:患者随访0~60个月,5年总生存率为36.2%,中位生存时间为53.0±1.461个月。K-M和对数秩检验结果显示,肿瘤的位置,分化程度,入侵深度,区域淋巴结受累,术后肿瘤分期与5年生存率降低相关(P<0.05)。采用多因素Cox风险回归模型分析组织学分化程度(HR=1.441;95%CI=1.049-1.979;P=0.024),区域淋巴结(HR=1.626;95%CI=1.160-2.279;P=0.005),和pTNM分期(HR=2.266;95%CI=1.335-3.847;P=0.002),这是生存率低下的独立危险因素。肿瘤部位(P=0.191),肿瘤浸润深度(P=0.579)和肿瘤大小(P=0.324)不是独立危险因素。
结论:肿瘤的分化程度,发现区域淋巴结转移和术后病理分期是进展期胃癌患者5年总生存率的独立危险因素。规范合理的淋巴结清扫及准确的术后病理分期非常重要。