胃癌患者根治术后体重变化对预后的影响

The impact duration of post-operative weight losson progonosis of gastric cancer patients

目的探讨根治术后胃癌患者体重变化与预后的关系。方法选取有完整术后病理及随访资料的根治术后胃癌患者共155例,所有患者未接受术前新辅助放、化疗,收集所有患者的临床、病理资料,并随访患者术前、术后体重情况,COX多因素回归分析其对术后无病生存(disease free survival,DFS)的影响,Kaplan-Meier方法绘制术后DFS曲线并计算中位DFS。结果所有患者均出现不同程度的术后体重减轻;术后体重下降持续超过2个月提示更高的复发风险,卡方分析显示,其与年龄、肿瘤的N分期相关。COX回归分析表明,术后体重下降持续超过2个月是影响术后的独立预后因素(P<0.05)。术后体重下降持续不超过2个月及术后体重下降持续超过2个月的患者的术后中位DFS分别是69个月和63个月(P<0.001)。结论术后体重下降持续超过2个月是影响根治手术胃癌DFS的独立不良预后因素。

Objective To evaluate the impact of duration of post-operative weight loss on disease free survival(DFS)in patients who underwent radical surgery for gastric cancer.Patients and Methods A total of 155 patients who underwent radical surgery and did not receive neuadjuvant chemo-radiotherapy for gastric cancer were enrolled in this study.Pre-operative and post-operative body weight were recorded.The medical record of the patients was reviewed in detail and the characteristics of the patients and the findings of pathological examination were analyzed in order to find their potential association with DFS.Multivariate analysis using the COX regression method was conducted in order to identify the independent prognostic factors.The Kaplan-Meier method was used to plot DFS curves.Results Varying degrees of weight loss was observed in all patients.More than 2 months duration of post-operative weight loss was found to be corrected with higher relapse risk.Chi-square analysis showed significant correlation between duration of post-operative weight loss and age and N stage.COX regression analysis showed more than 2 months duration of post-operative weight loss was statistically significant associated with DFS of all the gastric cancer patients in this study(P<0.05).Median DFS of gastric cancer patients with less than 2 months duration of post-operative weight loss and more than 2 months duration of post-operative weight losswas 69 months and 63 months(P<0.05).Conclusion More than 2 months duration of post-operative weight loss is an independent prognostic factor for DFS for gastric cancer patients after radical operation.