胃癌根治术后早期复发的临床病理特点及预后分析

Clinicopathologic and prognostic factors related to early recurrence of gastric cancer after curative radical resection

目的:探讨胃癌根治术后早期复发的相关因素及预后分析。方法:回顾性分析235例胃癌根治术后复发患者的临床病理资料,对相关参数进行单因素和多因素分析。Kaplan-Meier法进行预后的生存分析。结果:235例患者平均复发时间为术后24.3个月,其中早期复发145例(≤2年),晚期复发90例(>2年)。单因素分析显示手术方式、肿瘤大小、脉管侵犯、浸润深度、淋巴结转移、TNM分期、术后化疗与早期复发相关(P<0.05)。多因素分析显示肿瘤大小(P=0.001)、淋巴结转移(P=0.007)、术后化疗(P=0.011)是早期复发的独立影响因素。生存分析显示肿瘤大小(P=0.013)、TNM分期(P<0.01)是预后的独立影响因素。结论:肿瘤大小、淋巴结转移、术后化疗是胃癌早期复发的独立影响因素,且预后与肿瘤大小、TNM分期密切相关。

Objective：To explore the clinicopathologic factors and prognosis related to early recurrence of gastric cancer after curative radical resection. Methods： A retrospective clinical analysis was made in 235 patients with gas-tric cancer,who recurred after curative radical resection. Clinicopathologic factors related to tumor recurrence were studied and survival analysis was performed using Kaplan - Meier plots. Results： The mean time from curative surgery to recurrence in 235 patients was 24. 3 months,among whom 145 experienced recurrence within 2 years （early recur-rence group） and 90 recurred more than 2 years （late recurrence group） . Univariate analysis showed that operation type,tumor size,lymphovascular invasion,depth of invasion,lymph node metastasis,TNM stage,adjuvant chemothera-py were associated with the time of recurrence （ P 〈 0. 05 ） . In multivariate analysis, tumor size （P = Q. 001） , lymph node metastasis （P =0. 007） and adjuvant chemotherapy （P = 0.011） were independent factors. Survival analysis showed that tumor size （P =0.013） and TNM stage （P 〈 0 .01 ） were independent prognostic factors. Conclusion：Tumor size,lymph node metastasis and adjuvant chemotherapy were independent factors of early recurrence with gas-tric cancer after curative radical resection. Tumor size and TNM stage were both important prognostic factors.