CAJ | 학술논문

目的探讨影响残胃癌患者长期生存的独立预后因素.方法回顾性分析1996年1月至2006年12月接受外科治疗的63例残胃癌患者的临床病理资料和随访结果,采用Kaplan-Meier 法进行生存分析,Log rank检验进行统计学比较,Cox比例风险模型进行多因素分析,以确定影响预后的独立因素.结果 63例患者中,行根治性切除术35例(其中联合脏器切除16例),姑息性手术28例.全组患者均获得随访,中位生存时间为21个月,1、3、5年总生存率分别为76.2％、31.7％和18.8％.单因素和多因素分析均显示,手术方式、病理分期和病理类型是影响残胃癌患者预后的独立因素(均P ＜0.05),而患者的性别、年龄、首次重建术式以及肿瘤部位与患者的预后无关(均P＞0.05).结论手术方式、病理分期和病理类型是残胃癌患者的预后影响因素.早期诊断和行根治性手术有助于提高残胃癌患者的生存率.
목적 탐토영향잔위암환자장기생존적독립예후인소.방법 회고성분석1996년1월지2006년12월접수외과치료적63례잔위암환자적림상병리자료화수방결과,채용Kaplan-Meier 법진행생존분석,Log rank검험진행통계학비교,Cox비례풍험모형진행다인소분석,이학정영향예후적독립인소.결과 63례환자중,행근치성절제술35례(기중연합장기절제16례),고식성수술28례.전조환자균획득수방,중위생존시간위21개월,1、3、5년총생존솔분별위76.2％、31.7％화18.8％.단인소화다인소분석균현시,수술방식、병리분기화병리류형시영향잔위암환자예후적독립인소(균P ＜0.05),이환자적성별、년령、수차중건술식이급종류부위여환자적예후무관(균P＞0.05).결론 수술방식、병리분기화병리류형시잔위암환자적예후영향인소.조기진단화행근치성수술유조우제고잔위암환자적생존솔.
Objective To investigate the independent prognostic factors of long-term survival for gastric stump cancer after radical resection.Methods The clinicopathological and follow-up data of 63patients with gastric stump cancer undergoing surgical treatment from January 1996 to December 2006 in our hospital were analyzed retrospectively,including age,gender,types of reconstruction,tumor location,histological types,TNM stages,surgical treatment,prognosis and etc.The survival was estimated using Kaplan-Meier method and compared using log-rank test.The effect of independent factors on prognosis was determined by Cox regression multivariate analysis. Results Radical resection was performed in 35patients,including combined multiple organ resection (n =16).Surgery was palliative in 28 patients.All the 63 patients were followed up.The median survival time of these 63 patients was 21 months,and the overall 1-,3-,5-year survival rates were 76.2％,31.7％ and 18.8％,respectively. Univariate and multivariate analysis showed that surgical procedure,clinical stage and histological type were independent prognostic factors of gastric stump cancer,while age,gender,type of reconstruction and tumor location were not significantly correlated with prognosis.Conclusions Radical resection,clinical stage and histological type are main prognostic factors for gastric stump cancer.Radical resection is an effective way to prolong the postoperative survival time in patients with gastric stump cancer,especially in the early stage.