影响Ⅲ～Ⅳ期胃癌患者生存及预后因素：附156例报道  

The factors affecting the survival and prognosis of patients with Ⅲ ～ Ⅳ gastric cancer： a report of 156 cases

作　　者：阮强[1] 崔书中[1] 张相良[1] 吴印兵[1] 唐鸿生[1] 

机构地区：[1]广州医科大学附属肿瘤医院腹外综合病区,广州510095

出　　处：《中国医师杂志》2016年第8期1185-1189,共5页Journal of Chinese Physician

基　　金：广州医科大学青年科研项目（2015A24）

摘　　要：目的 探讨影响Ⅲ～Ⅳ期胃癌患者生存及预后的因素.方法 对2006年9月1日至2012年12月31日156例Ⅲ～Ⅳ期胃癌患者进行回顾性研究,采用Kaplan-Meier法、Log-rank法和Cox比例风险模型多因素分析法来分析影响生存、预后的相关因素.结果 12例失访,随访结束时生存22例.全组中位生存时间为29.3个月,1、3、5年生存率分别为83.3％、37.8％和21.2％.单因素分析显示,肿瘤大小（P＜0.05）、TNM分期（P＜0.01）、手术根治程度（P＜0.01）、腹腔热灌注化疗（P＜0.O1）和术后全身静脉化疗（P＜0.01）与患者预后有关.多因素分析结果显示,TNM分期（P＜0.01）、手术根治程度（P＜0.01）、腹腔热灌注化疗（P＜0.01）和术后静脉化疗（P＜0.01）为影响Ⅲ～Ⅳ期胃癌患者预后的独立因素.结论 TNM分期、手术根治程度、腹腔热灌注化疗和术后化疗是影响进展期胃癌患者预后的独立因素.腹腔热灌注化疗和术后化疗能够改善进展期胃癌患者的预后,提高生存期.Objective To investigate the factors affecting the survival and prognosis of patients with stage Ⅲ～ Ⅳgastric cancers.Methods A total of 156 cases of Ⅲ ～ Ⅳ gastric cancer was studied retrospectively from September 1,2006 to December 31,2012.Kaplan-Meier analysis,Log-rank univariate analysis,Cox proportional hazards model analysis were used to analyze survival and prognostic factors.Results Twelve cases were lost,to the end of the follow-up,22 cases were alive.The median survival time was 29.3 months.1-year,3-year,and 5-year overall survival rates were 83.3%,37.8%,and 21.2%,respectively.Univariate analysis showed that tumor size,tumor node metastasis （TNM） staging,curative resection,hyperthermic intraperitoneal perfusion chemotherapy （HIPEC）,and postoperative chemotherapy were correlated with prognosis （P 〈0.05 for all）.Multivariate analysis showed that TNM staging,curative resection,HIPEC,and postoperative chemotherapy were independent prognostic factors （P 〈 0.01 for all）.Conclusions TNM staging,curative resection,hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy are the independent factors affecting the prognosis of stage Ⅲ～ Ⅳ gastric cancer after resection.Hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy can improve their survival.

关 键 词：胃肿瘤 预后 

分 类 号：R735.2[医药卫生—肿瘤]