胃癌D2根治术后短期并发症对患者远期生存率的影响  

Effect of Short-term Complications After D2 Radical Gastrectomy on Long-term Survival Rate of Gastric Cancer Patients

作　　者：林鹏航 林春霖 王琴 何若凡[1,2] 陈辉 黄永建[1] 杨树钢[1] 叶建新[1] 朱广伟[1] LIN Penghang;LIN Chunlin;WANG Qin;HE Ruofan;CHEN Hui;HUANG Yongjian;YANG Shugang;YE Jianxin;ZHU Guangwei(Department of Gastrointestinal Surgery 2 Section,The First Hospital Affiliated to Fujian Medical University,Institute of Abdominal Surgery,Key Laboratory of Accurate Diagnosis and Treatment of Cancer,Fuzhou 350005,China;Key Laboratory of Ministry of Education for Gastrointestinal Cancer,Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院胃肠外科二区,腹部外科研究所,肿瘤精准诊疗重点实验室,福州350005 [2]福建医科大学消化道恶性肿瘤教育部重点实验室,福州350005

出　　处：《肿瘤防治研究》2021年第6期625-630,共6页Cancer Research on Prevention and Treatment

基　　金：国家自然科学基金(81702424,81872364);福建省科技厅自然科学基金(2018J05127);福建省卫健委中青年骨干项目(2018-ZQN-46);国家卫健委临床重点专科建设项目(普通外科)资助课题(2013)。

摘　　要：目的探讨胃癌D2根治术后短期并发症对患者远期生存率的影响。方法采用回顾性病例对照研究方法,选取接受胃癌D2根治手术治疗的421例患者;根据术后短期有无并发症分为实验组(并发症组)76例和对照组(无并发症组)345例。为减小选择偏倚,通过倾向性得分匹配(PSM)平衡各组变量后,采用Kaplan-Meier生存分析法检验两组患者的远期生存率;Log rank法行单因素和Cox多因素分析筛选预后影响因素。结果实验组与对照组的远期生存率比较差异无统计学意义(P>0.05);组织学类型、淋巴结转移率和pTNM分期是影响患者术后远期生存率的独立危险因素。结论胃癌D2根治术后的短期并发症对患者远期生存率没有显著性影响,但积极预防并控制并发症具有一定的临床意义。Objective To investigate the effect of short-term complications after D2 radical gastrectomy on long-term survival rate of gastric cancer patients.Methods A retrospective case-control study was conducted on 421 patients with gastric cancer who underwent D2 radical gastrectomy.According to the shortterm postoperative complications,they were divided into experimental group(complication group,n=76)and control group(without complication group,n=345).In order to reduce the selection bias,the long-term survival rate of the two groups was tested by Kaplan-Meier survival analysis method after balancing the variables by propensity score matching(PSM).Log rank method was used for univariate analysis and Cox multivariate analysis was used for prognostic factors.Results There was no significant difference in long-term survival rate between the experimental group and the control group(P>0.05).Histological type,lymph node metastasis rate and pTNM stage were independent risk factors for long-term survival.Conclusion The short-term complications after D2 radical gastrectomy have no significant impact on the long-term survival rate of gastric cancer patients,but it has certain clinical significance to actively prevent and control complications.

关 键 词：胃癌D2根治术 术后短期并发症 生存分析 远期生存率 倾向性得分匹配法 

分 类 号：R735.2[医药卫生—肿瘤] R730.6[医药卫生—临床医学]