Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer.
Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer.
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DOI：
10.1016/0960-7404(92)90034-i
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发表时间：
1992-10-01
期刊：
影响因子：
--
通讯作者：
Nose, Y
中科院分区：
文献类型：
--
作者：
Moriguchi, S;Maehara, Y;Nose, Y
本研究的目的是明确进展期胃癌根治性切除术后腹膜扩散和血行转移的危险因素。在对405名患者的回顾分析中，168名患者死于肿瘤复发。死于胃癌的患者更有可能有大的侵袭性肿瘤，这些肿瘤已经扩散到整个胃，转移到淋巴结，并被胃癌细胞侵袭血管(P<；0.01或P<；0.05)。在168例死亡中，60例(35.7%)继发于血源性复发，53例(31.5%)与腹膜播散有关，19例(11.3%)与局部复发有关。多因素逐步Logistic回归分析显示浆膜侵犯(P<；0.01，相对风险=2.57)和Borrmann 4型(P<；0.01，相对风险=1.95)是腹膜转移的独立危险因素。淋巴结转移(P<；0.01，相对风险=2.62)和癌细胞侵袭血管(P<；0.05，相对风险=1.59)是血源性转移的最大危险因素。
The objective of the study was to define risk factors for peritoneal dissemination and haematogenous metastasis after curative resection of patients with an advanced gastric cancer. In retrospective analyses of 405 patients, 168 died of a tumour recurrence. Patients who died of gastric cancer were more likely to have large, invasive tumours which had spread throughout the stomach, metastasized to lymph nodes, and vessel invasion by gastric cancerous cells (P < 0.01 or P < 0.05). Of the 168 deaths, 60 (35.7%) were secondary to haematogenous recurrence, 53 (31.5%) were related to peritoneal dissemination, and 19 (11.3%) were related to a local recurrence. To determine the independent risk factors related to peritoneal dissemination and haematogenous metastasis, multivariate analyses using a stepwise logistic model suggested that serosal invasion (P < 0.01, relative risk = 2.57) and Borrmann type 4 (P < 0.01, relative risk = 1.95) were the greatest risk factors for peritoneal dissemination. The presence of lymph node metastasis (P < 0.01, relative risk = 2.62) and presence of vessel invasion by cancerous cells (P < 0.05, relative risk = 1.59) were the greatest risk factors for a haematogenous metastasis.