Clinicopathologic characteristics and prognosis for young gastric adenocarcinoma patients after curative resection
Clinicopathologic characteristics and prognosis for young gastric adenocarcinoma patients after curative resection
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DOI：
10.1245/s10434-008-9809-1
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发表时间：
2008-05-01
影响因子：
3.7
通讯作者：
Noh, Sung Hoon
中科院分区：
文献类型：
--
作者：
Lai, Ji Fu;Kim, Sungsoo;Noh, Sung Hoon
背景资料：从以前的研究结果表明，年轻患者胃腺癌（GC）的预后引起争议的年轻GC patients.Methods：作者研究了6954例胃癌患者接受根治性切除术。他们被分为三组：40岁或以下的人（“年轻人”，12.7%）; 41-65岁的人（“中年人”，66.7%）;和65岁以上的人（“老年人”，20.6%）。临床病理特征和总生存率进行了分析。结果：年轻患者主要是女性，肿瘤是组织学未分化。但在T4浸润、N3淋巴结转移和TNM IV期方面，青年患者的肿瘤特征与中老年患者相似。年轻患者的总生存率明显高于中年患者（P = 0.018）和老年患者（P <0.001）。按TNM分期分层，年轻患者在I期的总生存率高于中年患者，在I、II和IIIa期的总生存率高于老年患者。多因素分析表明，年龄是一个独立的预后因素（以及性别，手术类型，浸润深度，淋巴结状态）。结论：女性病例和肿瘤的组织学未分化的优势是年轻患者的独特特征。年轻患者在I期疾病根治性切除后可以获得生存益处。
Background: Conflicting results from previous studies on gastric adenocarcinoma (GC) in young patients have led to controversy surrounding the prognosis for young GC patients.Methods: The authors studied 6954 patients with GC who received curative resections. They were classified into three groups: those aged 40 years or less ("young," 12.7%); those aged 41-65 years ("middle-aged," 66.7%); and those aged more than 65 years ("elderly," 20.6%). Clinicopathologic characteristics and overall survival rates were analyzed.Results: Young patients were predominately female and had tumors that were histologically undifferentiated. However, in regard to T4 invasion, N3 lymph node metastasis, and TNM stage IV, the characteristics of the tumors of young patients were similar to those of middle-aged and elderly patients. Overall survival rate was significantly better in young patients than middle-aged patients (P = .018) and elderly patients (P < .001). Stratified by TNM stage, young patients showed better overall survival at stage I than middle-aged patients, and at stages I, II, and IIIa than elderly patients. Multivariate analysis indicated that age was an independent prognostic factor (as well as gender, operation type, depth of invasion, and lymph node status).Conclusions: The predominance of female cases and tumors that were histologically undifferentiated were distinctive characteristics in young patients. Young patients could gain a survival benefit after curative resection with stage I disease.