T4a期胃癌根治术后280例患者的预后分析

Prognostic analysis of GAO Wei-feng, LIANG Gastric Cancer, Tianjin Prevention and Therapy, 280 patients with T4a gastric cancer who underwent curative resection

目的探讨影响．T4a期胃癌根治术后患者远期生存和复发的因素。方法回顾性分析1997年1月至2003年12月间天津医科大学附属肿瘤医院收治的280例T4a期胃癌根治术患者的临床和随访资料。结果280例患者术后5年生存率为50．0％：术后复发158例（56．4％）．3年无瘤生存率为57．5％。多因素分析显示．淋巴结转移数目和淋巴结转移率（MLR）是影响术后患者总体生存期的独立因素（均P〈0．05）：淋巴结转移范围是影响术后无病生存期的独立因素（P〈0．05）；淋巴结转移范围、淋巴结转移数目和MLR是影响术后复发的独立因素（均P〈0．05）。结论淋巴结转移数日、范围和MLR是影响La期胃癌患者根治术后远期生存和复发的主要因素。

Objective To evaluate the predicators of survival and recurrence after curative resection for gastric cancer patients with serosal invasion. Methods Clinical and follow-up data of 280 patients with T4a gastric cancer （according to the 7th UICC TNM Classification for gastric cancer） who underwent curative resection for gastric cancer between January 1997 and December 2003 were analyzed retrospectively. Results Five-year survival rate of these 280 patients was 50.0% and 158 patients （56.4%） presented with recurrence after surgery. The 3-year disease-free survival rate was 57.5%. The number of lymph node metastasis and metastatic lymph node ratio （MLR） were identified as the independent predicators for overall survival（P〈0.05）. The extent of lymph node metastasis was identified as the independent predicators for disease free survival （P〈0.05）. The extent of lymph node metastasis, the number of lymph node metastasis, and MLR were identified as the independent predicators for recurrence after surgery （P〈0.05）. Conclusions The number of lymph node metastases, extent of lymph node metastasis and MLR are independent predictors of overall survival and recurrence in T4a gastric cancer patients after curative resection.