Risk factors for recurrence of gastric cancer after curative laparoscopic gastrectomy
Risk factors for recurrence of gastric cancer after curative laparoscopic gastrectomy
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DOI：
10.2152/jmi.64.79
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发表时间：
2017-02-01
影响因子：
0.7
通讯作者：
Takasu, Chie
中科院分区：
文献类型：
--
作者：
Kashihara, Hideya;Shimada, Mitsuo;Takasu, Chie
引言：腹腔镜胃切除术（LG）治疗早期胃癌具有良好的结局。本研究的目的是确定复发的危险因素后LG. Methods：212例胃癌行胃切除术（LG：143，开放胃切除术，OG：69）。单因素分析比较LG组和OG组的总生存期（OS）和无病生存期（DFS）。多因素分析用于评估LG. Results后复发的危险因素：在LG，6例复发观察（肝脏：2，腹膜：4）。LG术后无淋巴结或穿刺口复发，5年无病生存率为91.4%。基于5年无病生存率的单因素分析，确定了三个负预后因素-淋巴结转移、淋巴浸润和静脉浸润。复发的独立危险因素是淋巴结转移。LG和OG在IA、IB、IIA和IIB期组之间的5年DFS无显著差异。LG或OG术后复发的独立危险因素是肿瘤浸润>=粘膜肌层和淋巴结转移。结论：LG后DFS与OG后相当。淋巴结转移是胃癌术后复发的独立危险因素。
Introduction : Curative laparoscopic gastrectomy (LG) is associated with good outcomes when performed for early gastric cancers. The aim of this study was to identify risk factors for recurrence after LG. Methods : 212 patients with gastric cancer who underwent gastrectomy were enrolled (LG : 143, open gastrectomy, OG : 69). Univariate analysis was used to assess overall (OS) and disease-free survival (DFS) in LG and OG group. Multivariate analysis was used to assess risk factors for recurrence after LG. Results : In LG, six cases of recurrence were observed (liver : 2, peritoneum : 4). Neither lymph node nor port-site recurrences were evident after LG. The 5-year DFS after LG was 91.4%. Based on univariate analysis of 5-year DFS, three negative prognostic factors-lymph node metastasis, lymphatic invasion, and venous invasion-were identified. The independent risk factor for recurrence of LG was lymph node metastasis. LG and OG showed no significant differences in 5-year DFS among Stage IA, IB, IIA, and IIB groups. Independent risk factors for recurrence after LG or OG were tumor invasion >= muscularis mucosa and lymph node metastasis. Conclusions : DFS following LG is comparable to that following OG. Lymph node metastasis is an independent risk factor for gastric cancer recurrence after LG.