胃癌根治术后早期复发转移的相关因素分析

Risk factors of early recurrence in patients with gastric cancer after curative resection

目的探讨胃癌术后早期复发转移的相关危险因素。方法回顾性分析2001年1月至2004年12月间收治的141例行胃癌根治术后复发转移患者的临床病理资料，探讨胃癌术后早期复发（≤1年，82例）的临床病理因素及其预后。结果早期复发组与对照组（1年后复发转移，59例）的1、3年存活率分别为36，6％、2．4％和100％、45．8％，两组存活率差异有统计学意义（P〈0．05）；早期复发组、对照组复发转移后中位生存时间分别为3、5个月，两组差异有统计学意义（P〈0．05）。单因素分析显示年龄、肿瘤大体分型、肿瘤部位、浸润深度、淋巴结转移、TNM分期、淋巴结转移率、术式、腹腔热灌注化疗与胃癌根治术后早期复发转移的发生相关（P〈0．05）；多因素分析发现淋巴结转移、淋巴结转移率及腹腔热灌注化疗是影响胃癌根治术后早期复发转移发生的独立因素（P〈0．05）。结论早期复发转移病例生存率低、复发转移术后生存时间短。淋巴结转移、淋巴结转移率及腹腔热灌注化疗是影响胃癌根治术后早期复发转移的独立危险因素。

Objective To analyze the clinical and pathologic influencing factors of early recurrence in patents with gastric cancer after radical gastrectomy. Methods Clinicopathological data of 141 patients with recurrence after curative gastrectomy for gastric cancer from January 2001 to December 2004 were analyzed rctrospectively. Risk factors correlated with tumor early recurrence and survival difference between early recurrence group （ 〈 1 year, 82 cases ） and control group （ 1 year after, 59 cases ） were assessed. Results The l- and 3-year survival rates of in early recurrence group and control group were 36. 6%, 2.4% and 100% , 45.8%, respectively （P 〈0.05）. The median survival time after recurrence in the two groups was 3, 5 months, respectively （ P 〈 0. 05 ）. Univariate analysis showed that the age, tumor Borrmann type, tumor site, invasive depth, lymph node metastasis, pTNM stage, metastatic lymph node ratio, surgical procedure and intraperitoneal hyperthermic perfusion chemotherapy （IHPC） were significant factors associated with early recurrence after curative gastrectomy for gastric cancer （ P 〈 0.05 ） . Lymph node metastasis, metastatic lymph node ratio and IHPC were independent factors associate with early recurrence after curative gastrectomy on multivariate analysis （ P 〈 0. 05 ）. Conclusions The patients with early recurrence after the radical gastrectomy have a poorer survival compared with cases recur later. Lymph node metastasis, metastatic lymph node ratio and IHPC are independent factors associate with early recurrence after curative gastrectomy for gastric cancer.