CAJ | 학술논문

目的探讨进展期胃癌根治术后复发患者的预后影响因素.方法对2001年1月至2005年1月收治的进展期胃癌根治术后复发的163例患者进行回顾性研究,根据诊断复发时患者有或无临床症状及体征,分为症状复发组和无症状复发组.结果症状复发组72例,无症状复发组91例.两组患者的淋巴结分期差异有统计学意义(P＜0.05).无症状复发组中位总体生存期为19.8个月,显著长于症状复发组的15.7个月(P＜0.05);无症状复发组复发后中位生存期为9.5个月,显著长于症状复发组的4.8个月(P＜0.01).症状复发组的中位无复发间期为10.0个月,长于无症状复发组的9.2个月(P＜0.05).单因素分析结果显示,胃癌术后化疗(P＜0.05)、复发类型(P＜0.01)、临床分期(P＜0.01)、无复发间期(P＜0.05)和复发后手术(P＜0.01)是影响胃癌复发患者预后的主要因素;多因素分析结果显示,临床分期(P＜0.01)、复发类型(P＜0.01)、无复发间期(P＜0.05)和复发后手术(P＜0.05)是影响胃癌复发患者预后的独立因素.结论胃癌复发患者的预后较差,胃癌术后2年内是检测随访的重点,积极行再手术治疗有助于延长患者的生存时间.
목적 탐토진전기위암근치술후복발환자적예후영향인소.방법 대2001년1월지2005년1월수치적진전기위암근치술후복발적163례환자진행회고성연구,근거진단복발시환자유혹무림상증상급체정,분위증상복발조화무증상복발조.결과증상복발조72례,무증상복발조91례.량조환자적림파결분기차이유통계학의의(P＜0.05).무증상복발조중위총체생존기위19.8개월,현저장우증상복발조적15.7개월(P＜0.05);무증상복발조복발후중위생존기위9.5개월,현저장우증상복발조적4.8개월(P＜0.01).증상복발조적중위무복발간기위10.0개월,장우무증상복발조적9.2개월(P＜0.05).단인소분석결과현시,위암술후화료(P＜0.05)、복발류형(P＜0.01)、림상분기(P＜0.01)、무복발간기(P＜0.05)화복발후수술(P＜0.01)시영향위암복발환자예후적주요인소;다인소분석결과현시,림상분기(P＜0.01)、복발류형(P＜0.01)、무복발간기(P＜0.05)화복발후수술(P＜0.05)시영향위암복발환자예후적독립인소.결론 위암복발환자적예후교차,위암술후2년내시검측수방적중점,적겁행재수술치료유조우연장환자적생존시간.
Objective To investigate the clinical features and prognosis of recurrent gastric cancer. Methods Clinical data of 163 patients with recurrent gastric cancer from Jan. 2001 to Jan.2005 were reviewed. Patients were compared between those with and without symptoms. Results Seventy-two patients(44.2%) were symptomatic, while 91(55.8%)were asymptomatic. There were significant differences in lymph node metastasis between the two groups (P＜0.05). The median overall survival was significantly longer in asymptomatic patients (19.8 vs. 15.7 months, P＜0.05).Post-recurrence survival was also longer in the asymptomatic group (9.5 vs. 4.8 months, P＜0.01 ).The median recurrence-free interval in asymptomatic patients was 10.0 months, which was significantly longer than that in the symptomatic patients (9.2 months, P＜0.05). On univariate survival analysis,post-gastrectomy chemotherapy (P＜0.05), symptoms of recurrence (P＜0.01), TNM staging (P＜0.01),recurrence-free interval (P＜0.01), and reoperation (P＜0.01) were associated with the prognosis. On multivariable analysis, TNM staging (P＜0.01), symptoms of recurrence (P＜0.01), recurrence-free interval (P＜0.05), and reoperation(P＜0.05) were independent risk factors. Conclusions Patients with recurrent gastric cancer have poor prognosis. Close monitoring and active follow-up of patients with gastric cancer should be conducted during the first two years after operation. Reoperation may improve survival in patients with recurrent gastric cancer.