2035例早期贲门癌患者根治术后5年生存状况及死亡危险因素分析  

Five-year overall survival and death risk factors of 2035patients with early gastric cardiac cancer after radical resection

作　　者：尤朵 赵学科[1] 徐瑞华 魏梦霞 李新敏[2] 陈亚杰 孙琳[1] 白合林 马琳琳 乔佳欣 李吉林 王立东[1] YOU Duo;ZHAO Xue-ke;XU Rui-hua;WEI Meng-xia;LI Xin-min;CHEN Ya-jie;SUN Lin;BAI He-lin;MA Lin-lin;QIAO Jia-xin;LI Ji-lin;WANG Li-dong(State Key Laboratory of Esophageal Cancer Prevention&Treatment of The First Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Pathology,Zhengzhou Maternal and Child Health Hospital,Zhengzhou,Henan 450012,China;Department of Pathology,Linzhou Esophageal Cancer Hospital,Linzhou,Henan 456592,China)

机构地区：[1]郑州大学第一附属医院省部共建食管癌防治国家重点实验室,河南郑州450052 [2]郑州市妇幼保健院病理科,河南郑州450012 [3]林州市食管癌医院病理科,河南林州456592

出　　处：《中华实用诊断与治疗杂志》2023年第1期7-10,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金面上项目(81872032);国家自然科学基金重点项目(U1804262)。

摘　　要：目的观察早期贲门癌患者根治术后5年生存情况及死亡原因,探讨术后5年死亡的危险因素。方法2035例早期贲门癌患者均行贲门癌根治术(R0切除)并随访至2022年3月,采用Kaplan-Meier法分析5年生存概率,统计术后5年死亡原因。术后5年因肿瘤复发/转移死亡474例为死亡组,生存患者1516例为生存组,采用Cox比例风险回归模型分析早期贲门癌患者根治术后5年因肿瘤复发/转移死亡的危险因素。结果2035例患者术后1、2、3、4、5年生存概率分别为94.1%、87.5%、80.8%、75.1%和69.8%。截至2022年3月,2035例患者死亡801例,其中术后5年死亡519例(64.8%)。519例中,死于贲门癌复发/转移474例(91.3%),心脑血管疾病13例(2.5%),术后并发症10例(1.9%),其他疾病9例(1.7%),自杀3例(0.6%),意外2例(0.4%),自然死亡2例(0.4%),原因不详6例(1.2%);术后1、2、3、4、5年死亡率分别为22.5%(117/519)、23.7%(123/519)、21.4%(111/519)、17.1%(89/519)、15.2%(79/519)。年龄>60岁(HR=1.423,95%CI:1.182~1.712,P<0.001)、肿瘤浸润程度为T_(2)(HR=1.469,95%CI:1.223~1.765,P<0.001)是早期贲门癌患者根治术后5年因肿瘤复发/转移死亡的危险因素。结论早期贲门癌患者5年生存概率为69.8%,术后5年死亡的主要原因为肿瘤复发/转移;年龄>60岁、较深肿瘤浸润程度是早期贲门癌患者根治术后5年死亡的独立危险因素。Objective To analyze the 5-year survival and death cause of patients with early gastric cardiac cancer after radical resection,and to investigate the risk factors of death 5years after operation.Methods Totally 2035patients with early gastric cardiac cancer underwent radical resection(R0resection)and were followed up till March 2022.The 5-year survival probablility was evaluated by Kaplan-Meier method and the cause of death 5years after operation was analyzed.According to the 5-year survival results,474patients died from recurrence and metastasis(death group)and another 1516patients survived(survival group).Cox proportional hazard regression model was used to analyze the risk factors of death due to recurrence/metastasis 5years after radical resection.Results The 1-,2-,3-,4-and 5-year survival probabilities of 2035patients with early gastric cardiac cancer were 94.1%,87.5%,80.8%,75.1%and 69.8%,respectively.Till March 2022,801patients died,in which 519(64.8%)died within 5years after radical resection.In 519patients,474(91.3%)died from recurrence/metastasis,13(2.5%)died of cardiocerebrovascular diseases,10(1.9%)died from postoperative complications,9(1.7%)died of other diseases,3(0.6%)committed suicide,2(0.4%)died from accidents,2(0.4%)died of natural causes,and 6(1.2%)died with unknown causes.The postoperative 1-,2-,3-,4-and 5-year death rates were 22.5%(117/519),23.7%(123/519),21.4%(111/519),17.1%(89/519)and 15.2%(79/519),respectively.Age>60years old(HR=1.423,95%CI:1.182-1.712,P<0.001)and tumor invasion degree of T_(2)(HR=1.469,95%CI:1.223-1.765,P<0.001)were the risk factors of death due to recurrence/metastasis 5 years after radical resection in patients with early gastric cardiac cancer.Conclusions The 5-year overall survival probability of patients with gastric cardiac cancer is 69.8%,and the main cause of death within 5years after radical resection surgery is recurrence/metastasis.Age>60years old and deep tumor invasion are the independent risk factors of 5-year death of patients with early gastric cardiac ca

关 键 词：早期贲门癌 贲门癌根治术 5年生存率 危险因素 

分 类 号：R735[医药卫生—肿瘤]