80岁以上高龄胃癌患者的临床病理及预后分析  

Surgical outcomes and survival analysis for gastric cancer patients over 80 years old

作　　者：宋国栋[1] 沈洪[1] 王力[1] 李盟[1] 李强[1] 牛远杰[1] 

机构地区：[1]天津医科大学第二医院胃肠外科,300211

出　　处：《中华普通外科杂志》2016年第6期463-467,共5页Chinese Journal of General Surgery

基　　金：天津市卫生和计划生育委员会科技基金资助项目（2015KZ096）

摘　　要：目的分析高龄胃癌患者的临床病理特征及预后，探讨高龄胃癌患者合理的治疗方式。方法回顾性分析2000年1月至2010年12月天津医科大学第二医院收治的533例行手术治疗胃癌患者的临床病理资料，对比分析高龄胃癌患者组（年龄〉80岁，75例）与非高龄胃癌患者组（年龄〈80岁，458例）之间的临床病理特征及预后差异。结果两组患者的术前合并基础疾病、术前贫血以及术后病理分化程度相比差异均有统计学意义（X^2=9．634，P=0．002；X^2=6．759，P=0．009；X^2=3．894，P=0．048）。两组患者的术后并发症发生率和术后死亡率相比差异均无统计学意义（X^2=0．088，P=0．766；X^2=0．494，P=0．482）。本组患者的5年生存率为31．1％，高龄胃癌组为21．1％，非高龄胃癌组为32．8％，两组相比差异无统计学意义（X^2=0．631，P=0．427）。淋巴结清扫范围（P=0．000）、手术根治程度（P=0．007）、淋巴结转移（P=0．001）以及TNM分期（P=0．010）是非高龄胃癌组的独立预后因素；高龄胃癌组中，TNM分期为唯一独立预后因素（P=0．000）。结论高龄胃癌患者手术合并症及生存情况与年龄较低胃癌患者相当。Objective To evaluate the surgical outcomes in octogenarians and older of gastric cancer and to identify the reasonable therapy for these patients. Methods From Jan 2000 to Dec 2010, the clinicopathological data of 533 patients with gastric cancer undergoing gastrectomy were analyzed retrospectively. We conducted comparative analysis for the differences in clinieopathological characteristics and prognosis between 80 years and older （≥80 y, n = 75） and younger （ 〈 80 y, n = 458）. Results There were significant differences in comorbidities, anemia and histological type between the two groups. There was no significant difference in operative morbidity and mortality between the two groups. The 5-year survival rate for octogenarians was lower （21.1%） than nonoctogenarians （32.8%）, but with no significant difference. TNM stage was the only independent prognostic factor for gastric cancer in octogenarians. Conclusions Older gastric cancer patients have comparative postoporative complication rate and survival with younger patients.

关 键 词：胃肿瘤 老年人 80以上 预后 病理学 临床 

分 类 号：R735.2[医药卫生—肿瘤]