摘要
目的:本研究拟探讨多原发性胃癌的临床特点,分析影响多原发性胃癌预后的相关因素。方法:回顾性总结中山大学肿瘤防治中心1964～2004年58例多原发性胃癌的临床资料。将性别、年龄、家族史、手术切除率、病理类型、周围脏器侵犯、术后病理分期(pTNM)等临床病理参数与同期单发性胃癌对比;以1984年为界,比较多原发性胃癌在同期胃癌中的构成比;COX回归模型分析患者的预后。结果:多原发性胃癌和同期单发性胃癌的临床病理参数对比无显著性差异(P>0.05);以1984年为界,前后20年多原发性胃癌占同期胃癌的比例有显著性差异(3.66%:1.73%,P<0.05);根治性切除、姑息切除、短路术、单纯探查或活检患者的中位生存期分别为570、303、108、101天;术后进行辅助化疗患者的中位生存期494天,单纯手术者218天;Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的中位生存时间分别为1204、698、264、139天,上述结果均有显著性差异(P<0.05)。COX回归结果:手术方式、pTNM分期、综合治疗是影响多原发性胃癌预后的独立因素。结论:多原发性胃癌和胃单发癌的临床特点无显著性差异。努力提高多原发性胃癌的早期诊断水平及手术的切除率或根治性切除率,并辅以必要的辅助治疗,将极大改善患者的预后。
Objective： To investigate clinical features and related prognostic factors of muhiple Primary gastric carcinomas （MPGC）. Methods： The clinical data of 58 patients with MPGC, admitted in the Cancer Center of Zhongshan University from 1964 to 2004, were reviewed. Clinical pathological parameters, such as the gender, age, family history, rate of resectability, pathological types and adjacent viscera affected, as well as pTNM staging, were compared with homochronous single primary gastric carcinoma （HSPGC）. Based on data from 1984, the Cox regression model was used to analyze prognosis of the patients. Results： There was no significant difference when comparing the clinieopathologic parameters of the MPGC and HSPGC （P〉0.05）. Based on data from 1984, there was a significant difference in the ratio of MPGC in the homochronous primary gastric carcinomas （HPGC） during a period of over 20 years, with the year 1984 as a middle demarcation （3.66% vs. 1.73%, P〈0.05）. The median survival time of the patients who received radical reseetion, palliative resection, by-pass, simple exploration or biopsy was 570 days, 303, 108 and 101 clays, respectively. The median survival time （MST） for the cases with adjuvant chemotherapy after surgery was 494 clays, while the MST for the cases receiving surgery alone without adjuvant chemotherapy was 218 days. Furthermore, the median survival time for the patients with stage Ⅰ, Ⅱ, Ⅲ and Ⅳ disease was 1204, 698, 264 and 139 days, respectively. Significant difference was observed in all of the above comparisons （P〈0.05）. Cox regression analysis demonstrated that the surgical method, pTNM stage, and combined therapy were independent prognostic factors for MPGC. Conclusion： There is no significant difference in clinical features between MPGC and HSPGC. Prognosis for patients with MPGC will improve only if early diagnosis and the curative resection rate are enhanced. Adjuvant chemotherapy is still necessary.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第5期261-265,共5页
Chinese Journal of Clinical Oncology
关键词
多原发癌
胃癌
综合治疗
预后
Multiple primary carcinomas
Stomach neoplasm
Combined therapy
Prognosis
