Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period
Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period
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DOI：
10.1002/bjs.7310
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发表时间：
2011-02-01
影响因子：
9.6
通讯作者：
Yang, H. -K.
中科院分区：
文献类型：
--
作者：
Ahn, H. S.;Lee, H. -J.;Yang, H. -K.
背景：西方世界胃癌的模式正在发生变化，胃上部肿瘤的比例增加。本研究的目的是调查在远东高发区的一个机构中胃癌切除患者的临床病理特征和生存率的变化。方法：我们比较了连续四个时期在首尔国立大学医院接受胃切除术的胃癌患者的临床特征和病理结果结果：1986-1990年、1991-1995年、1996-2000年、2001-2006年共收治12 026例患者。平均年龄从第一阶段的53.4岁增加到最后阶段的57.4岁（P < 0.001）。70岁或70岁以上患者的比例也有所增加，在最后一个时期达到16.1%。上三分之一的癌症从第一阶段的5.3%增加到第四阶段的14.0%（P < 0.001）。早期胃癌（病理T1）在四个时间间隔内持续增加，从24.8%增加到48.9%（P < 0.001）。总的5年生存率从第一阶段的64.0%增加到最后阶段的73.2%（P < 0.001），并且这种生存改善在40岁或以上的患者中是明显的。早期胃癌的比例和总生存率逐渐增加，尤其是40岁以上的患者。
Background: The pattern of gastric cancer in the Western world is changing, with an increased proportion of tumours in the upper stomach. The aim of this study was to investigate changes in clinicopathological features and survival of patients with resected gastric cancer at a single institution, in an area of high incidence in the Far East.Methods: Clinical features and pathological findings were compared in patients with gastric cancer who underwent gastrectomy at Seoul National University Hospital during four consecutive periods (1986-1990, 1991-1995, 1996-2000 and 2001-2006).Results: There were 12 026 patients. The mean age increased from 53.4 years in the first period to 57.4 years in the last (P < 0.001). The proportion of patients aged 70 years or older also increased, reaching 16.1 per cent in the final period. Upper-third cancer increased from 5.3 per cent in the first period to 14.0 per cent in the fourth (P < 0.001). Early gastric cancer (pathological T1) increased continuously over the four time intervals, from 24.8 to 48.9 per cent (P < 0.001). The overall 5-year survival rate increased from 64.0 per cent in the first period to 73.2 per cent at the end (P < 0.001), and this survival improvement was apparent in patients aged 40 years or more.Conclusion: The mean age of patients with gastric cancer has increased during the past 20 years. The proportion of early gastric cancer and overall survival have gradually increased, especially in patients aged over 40 years.