老年胃癌患者D2根治术预后多因素分析

Multivariate Prognostic Analysis in Elderly Gastric Carcinoma Patients after D2 Radical Resection

目的分析影响老年胃癌患者D2根治术后预后因素,提高对老年胃癌的认识及治疗水平。方法回顾性分析2002年1月—2009年8月收治并行胃癌D2根治手术的老年胃癌患者的临床病理资料,符合纳入标准的436例患者共随访217例,建立数据库用SPSS 13.0统计软件进行分析。结果单因素分析表明,老年胃癌D2根治术后患者预后因素包括:肿瘤大小、大体类型、组织学类型、浸润深度、TNM分期、淋巴结转移个数和淋巴管癌栓(P<0.05);性别、肿瘤部位、手术方式及化疗与预后无相关性(P>0.05)。多因素回归分析提示:组织学类型、浸润深度和淋巴结转移个数是影响预后的独立因素。结论组织学类型、浸润深度和淋巴结转移个数是老年胃癌患者D2根治术后预后的独立影响因素,细化后的淋巴结分期更有助于老年胃癌术后患者预后的预测评估。

Objective To analyze the clinical and pathological factors that affect the prognosis of elderly gastric cancer patients after D2 radical resection,to raise awareness and treatment level of elderly patients with gastric cancer. Methods This research retrospectively analyzed the clinical and pathologicaldata of the elderly gastric cancer patients who underwent D2 radical resection from January 2002 to August 2009. In accordance with the inclusion criteria of 436 patients were followed up in 217 cases. A database was established for SPSS13. 0 statistical software analysis. Results Survival curve analysis showed that the prognosis of elderly gastric cancer patients after D2 radical resection was correlated with tumor size,gross type,histological type,depth of invasion,TNM stage,the number of lymph node metastasis and lymphatic cancer embolus（ P〈0. 05）. No correlation was found in gender,tumor location,surgical procedure and chemotherapy（ P〉0. 05）. Multiple regression analysis showed that histological type,depth of invasion and the number of lymph node metastasis of gastric cancer were independent prognostic factors. Conclusion The histological type,depth of invasion and the number of lymph nodes metastasis are independent prognostic factors in elderly patients with gastric cancer after radical operation of D2.The refinement of lymph node staging is more helpful in evaluating the prognosis of elderly patients with gastric cancer after operation.