Clinicopathologic characteristics of gastric cancer in a young patient population
Clinicopathologic characteristics of gastric cancer in a young patient population
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DOI：
10.1016/j.gassur.2003.12.009
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发表时间：
2004-03-01
影响因子：
3.2
通讯作者：
Medina-Franco, H
中科院分区：
文献类型：
--
作者：
Ramos-De la Medina, A;Salgado-Nesme, N;Medina-Franco, H
本研究的目的是分析一所三级转诊大学医院的年轻胃癌患者的临床病理特征，特别注意遗传性胃癌。回顾性审查了1987年1月1日至2001年12月31日期间诊断时年龄在40岁或以下的所有患者的图表。分析人口统计学变量、胃癌家族史、临床病理特征和治疗相关变量。总生存期是主要的结局变量。生存曲线采用Kaplan-Meier法绘制，单因素分析采用log-rank检验，多因素分析采用考克斯回归。在P < 0.05时认为有显著性。在研究期间，我们的机构共观察到558例胃癌病例，其中83例（14.8%）为40岁或以下的患者。患者平均年龄为33.2岁。45例患者（54.2%）为男性。14例（16.9%）有胃癌家族史。5例患者（6%）符合遗传性胃癌的标准。88%的患者进行了手术，但只有35%的手术具有治愈目的。手术死亡率为2.4%。在单因素分析中，晚期肿瘤分期、低白蛋白血症、低体力状态、弥漫型、胃肿瘤位置、非治愈性手术和缺乏辅助化疗对生存率有显著的负面影响。多因素分析显示，晚期肿瘤分期、腹主动脉瘤位置和未行辅助化疗与预后不良显著相关。胃癌家族史或遗传性胃癌对预后无影响。在我院年轻患者中胃癌发病率较高。大多数患者处于晚期，这有利于较差的总生存率。胃癌家族史或遗传性胃癌对生存率无显著影响。完全切除和辅助化疗似乎是延长生存期的唯一机会。(C)2004年，消化道外科学会。
The aim of this study was to analyze the clinicopathologic characteristics of young patients with gastric cancer with special attention to hereditary gastric cancer in a tertiary referral university hospital. Charts from all patients 40 years of age or younger at the time of diagnosis, during the period from January 1, 1987 to December 31, 2001, were retrospectively reviewed. Demographic variables, family history of gastric cancer, clinicopathologic characteristics, and treatment-related variables were analyzed. Overall survival was the main outcome variable. Survival curves were constructed by means of the Kaplan-Meier method, univariate anlaysis was performed with the log-rank test, and multivariate analysis with Cox regression. Significance was considered at P < 0.05. During the study period, 558 cases of gastric cancer were seen at our institution, 83 (14.8%) were in patients 40 years of age or younger. Mean patient age was 33.2 years. Forty-five patients (54.2%) were male. Fourteen patients (16.9%) had a family history of gastric cancer. Five patients (6%) fulfilled the criteria of hereditary gastric cancer. Surgery was performed in 88% of patients, but only 35% of the operations had a curative intent. Operative mortality was 2.4%. On univariate analysis, advanced tumor stage, hypoalbuminemia, low performance status, diffuse type, pangastric tumor location, noncurative surgery, and lack of adjuvant chemotherapy had a significant negative impact on survival. On multivariate analysis, advanced tumor stage, pangastric tumor location, and absence of adjuvant chemotherapy were significantly associated with poor prognosis. Family history of gastric cancer or hereditary gastric cancer did not have any impact on prognosis. There is a high frequency of gastric cancer in young patients at our institution. Most patients present in advanced stages, which favors a poor overall survival. Family history of gastric cancer or hereditary gastric cancer did not have a significant impact on survival. Complete resection and adjuvant chemotherapy appeared to confer the only chance of prolonged survival. (C) 2004 The Society for Surgery of the Alimentary Tract.