中晚期胃癌患者预后相关因素的回顾性分析

Retrospective analysis of prognostic factors in patients with advanced gastric cancer

目的分析影响中晚期胃癌患者预后的危险因素,为识别高危人群、指导临床治疗提供依据。方法回顾性分析2017年1月至2021年12月于舟山市中医院住院的282例中晚期胃癌患者的临床资料,通过电话随访和定期复查等方式获得患者的生存结局。采用Kaplan-Meier法对总生存(overall survival,OS)进行分析,采用单因素及多因素COX回归模型分析临床特征对中晚期胃癌患者OS的影响。结果282例中晚期胃癌患者的中位OS为10.0个月。单因素分析结果显示,是否一线化疗、是否中药治疗、体质量指数(body mass index,BMI)、卡氏功能状态(Karnofsky performance status,KPS)评分、血红蛋白(hemoglobin,Hb)水平、白蛋白(albumin,Alb)水平均是患者生存预后的影响因素(P<0.05);多因素COX回归模型分析发现,是否一线化疗、BMI、KPS评分、Alb水平均是影响患者OS的独立危险因素(P<0.05)。结论BMI、Alb水平、KPS评分和一线化疗均是预测中晚期胃癌患者预后的独立危险因素,加强营养管理可能是改善中晚期胃癌患者生存结局的重要方式。

Objective To analyze the risk factors affecting the prognosis of patients with advanced gastric cancer,so as to provide evidence for identifying high-risk populations and guiding clinical treatment.Methods The clinical data of 282 patients with advanced gastric cancer who admitted to Zhoushan Hospital of Traditional Chinese Medicine from January 2017 to December 2021 were retrospectively analyzed.The survival outcome of patients was obtained by telephone follow-up and regular review.Kaplan-Meier method was used to analyze the overall survival(OS).Univariate and multivariate COX regression models were used to analyze the effects of clinical features on OS in patients with advanced gastric cancer.Results The median OS of 282 patients with advanced gastric cancer was 10.0 months.Univariate analysis showed that first-line chemotherapy,traditional Chinese medicine treatment,body mass index(BMI),Karnofsky performance status(KPS)score,hemoglobin(Hb)and albumin(Alb)were significantly correlated with the survival of patients with advanced gastric cancer(P<0.05).Multivariate COX regression models analysis showed that first-line chemotherapy,BMI,KPS score and Alb were independent risk factors affecting the survival of patients with advanced gastric cancer(P<0.05).Conclusion BMI,Alb,KPS score and first-line chemotherapy are independent risk factors for predicting the prognosis of patients with advanced gastric cancer,indicating nutrition management may be an important way to improve the outcome of patients with advanced gastric cancer.