新疆地区164例胃癌根治术后患者预后因素分析

Analysis of prognostic factors for 164cases of gastric cancer patients after radical resection in Xinjiang

目的:研究新疆地区胃癌根治术后患者的临床因素以及术后治疗对预后产生的影响。方法:对2003-01-2009-12新疆医科大学第一附属医院收治的胃癌根治术后患者164例进行回顾性分析,采用Kaplan-Meier法计算患者的生存率,用Log-rank检验进行单因素分析,应用Cox模型进行预后的多因素分析。结果:共82例患者死亡,中位随访时间28.0个月,1年累积生存率为78.7%(129/164),3年为42.1%(69/164),5年为6.7%(11/164),中位生存时间40.1个月。单因素分析显示,性别、民族、临床分期、浸润深度、淋巴结转移、网膜转移、组织学分化、肿瘤部位、切缘残留、肿瘤大小、脉管侵犯和术后治疗情况与预后相关,P<0.05;多因素分析证实,网膜转移(RR=8.564,P<0.01)、淋巴结转移(RR=4.092,P<0.01)、切缘残留(RR=3.282,P=0.002)、民族(RR=2.152,P=0.013)、浸润深度(RR=2.071,P=0.022)和肿瘤部位(RR=0.680,P=0.010)是影响胃癌预后独立的危险因子。结论:胃癌根治术后影响预后的独立因素按RR从高到低依次为网膜转移、淋巴结转移、切缘残留、民族、浸润深度和肿瘤部位。

OBJECTIVE：lb survey the survival status of gastric cancer patients of Han and Uighur in Xingjiang after radical resection and evaluate prognostic factors in these patients. METHODS： The clinical data for 164 patients with gastric cancer who underwent radical resection from 01-2003 to 12 2009 in the First Affitiated Hospital of Xinjiang Medical University were followed up and retrospectively reviewed. The life table,Kaplan-Meier and Cox proportional hazard analyses were used to evaluate the sur- vival status of these patients. RESULTS：A total of 82 patients died. The median follow-up time was 28.0 months,and the 1,3 and 5 year cumulative survival rates were 78.7 %（129/164） ,42.1 % （69/164） and 6.7 M （11/164） ,The median survival time was 40. 1 months; Univariate analysis indicated that gender, ethnicity,TNM stage, depth of invasion, lymph node metastasis, the omen turn metastasis,differentiation, tumor location, surgical margin residues, tumor size, vascular invasion and post-operative treatment were significant predictors for prognosis in these patients （P〈 0. 05）;Multivariate analysis showed that omentum metastasis （RR= 8. 564, P〈0. 01 ）,lymph node metastasis （RR = 4. 092, P〈0. 01 ）, marginal residues （RR = 3. 282, P = 0. 002）, ethnicity （RR=2. 152,P=0. 013） ,depth of invasion （RR=2. 071 ,P=0. 022） and tumor location （RR=0. 680,P=0. 010） were inde- pendent prognostic factors in these patients. CONCLUSIONS： The prognosis of patients with gastric cancer after radical resection is poor. Omentum metastasis, lymph node metastasis, cut-side residues, ethnicity, depth of invasion, surgical margin residues and tumor location are the most important prognostic factors for gastric carcinoma after surgical radical resection.