老年原发性胃癌患者经腹腔镜辅助远端胃癌根治术治疗后近期预后的影响因素

Influencing factors of short-term prognosis in elderly patients with primary gastric cancer after laparoscopic-assisted distal gastrectomy

目的 探讨老年原发性胃癌患者经腹腔镜辅助远端胃癌根治术(LADG)治疗后近期(术后1年)预后的影响因素。方法 选择60例接受LADG治疗的老年原发性胃癌患者,根据术后1年的随访结果将其分为生存组49例和死亡组11例。比较两组患者的基本资料、手术资料等,采用多因素Logistic回归模型分析影响其近期预后的因素。结果 生存组患者的并发症发生率低于死亡组,肿瘤直径小于死亡组,Bommann分型Ⅰ~Ⅱ型、组织分型为高分化、淋巴结清扫为D2、无血管侵犯、术后行辅助化疗的比例均高于死亡组,差异均具有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,肿瘤直径、Bommann分型、组织分型、淋巴结清扫情况、血管侵犯情况、术后辅助化疗情况均是老年原发性胃癌患者经LADG治疗后近期预后的独立影响因素(均P<0.05)。结论 肿瘤直径、Bommann分型、组织分型、淋巴结清扫情况、血管侵犯情况、术后是否行辅助化疗均是影响老年原发性胃癌患者LADG治疗后近期预后的因素。

Objective To investigate the influencing factors of short-term(1 year after operation) prognosis in elderly patients with primary gastric cancer after laparoscopic-assisted distal gastrectomy(LADG). Methods A total of 60 elderly patients with primary gastric cancer receiving LADG were selected and divided into a survival group(49 cases) and a death group(11 cases) according to the results of 1-year postoperative follow-up. The basic data and surgical data of the two groups were compared, and the multivariate logistic regression model was used to analyze the factors influencing the short-term prognosis. Results Patients in the survival group had a lower complication incidence and a smaller tumor diameter than those in the death group. The proportions of patients with Borrmann type I/II, highly differentiated histology, D2 lymph node dissection, no vascular invasion and postoperative adjuvant chemotherapy in the survival group were all higher than those in death group, with statistically significant differences(all P<0.05). The result of multivariate logistic regression analysis showed that tumor diameter, Bommann type, histological type, as well as conditions of lymph node dissection, vascular invasion and postoperative adjuvant chemotherapy were independent influencing factors of the short-term prognosis in elderly patients with primary gastric cancer after LADG treatment(all P<0.05). Conclusion Tumor diameter, Bommann type, histological type, conditions of lymph node dissection and vascular invasion, and with or without postoperative adjuvant chemotherapy are all factors that affect the short-term prognosis of elderly patients with primary gastric cancer after LADG treatment.