Adenocarcinoma of the stomach: Univariate and multivariate analysis of factors associated with survival
Adenocarcinoma of the stomach: Univariate and multivariate analysis of factors associated with survival
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DOI：
10.1097/00000421-200202000-00018
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发表时间：
2002-02-01
影响因子：
2.6
通讯作者：
Sosa-Sanchez, R
中科院分区：
文献类型：
--
作者：
Green, D;de Leon, SP;Sosa-Sanchez, R
胃癌是墨西哥最常见的消化道肿瘤。大多数患者被诊断为晚期，预计会有致命的结局，我们回顾性地回顾了150例患者的病历。进行单因素和多因素分析，以评估临床病理和治疗变量对生存的影响。大多数患者（75%）处于晚期，肿瘤分化较差。114名患者接受了手术，其中大部分是姑息性手术。47例患者接受化疗。在单因素分析中，重要的预后因素是TNM分期、化疗、手术尝试、运动状态、组织学和肿瘤部位（p < 0.001）。在多因素分析中，独立预后因素为TNM分期、组织学、肿瘤部位、手术方式和化疗（p < 0.01）。姑息化疗或辅助化疗患者的中位生存期分别为11.4个月和10.4个月，而未化疗患者的中位生存期为+/-3个月（p < 0.03）。接受化疗的非手术患者存活5.4个月，而未接受化疗的患者存活1.1个月。在亚组的分层分析消除了潜在的偏差后，化疗的有利影响持续存在。我们确定了影响生存的预后因素。即使是晚期患者也应该考虑化疗，无论是辅助治疗还是姑息治疗，因为我们一直发现化疗对中位生存时间有有利的影响。然而，III期前瞻性随机试验正在等待中。
Gastric cancer is the most frequent tumor of the digestive tract in Mexico. Most patients are diagnosed at advanced stages, and fatal outcome is expected, One hundred fifty patient charts Were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the impact of clinicopathologic and treatment variables on survival. Most patients (75%) were at advanced stages, harboring poorly differentiated tumors. Surgery, mostly palliative, was performed on 114 patients. Chemotherapy was administered to 47 patients. On univariate analysis, significant prognostic factors were TNM stage, chemotherapy, surgical attempt, performance status, histology, and tumor site (p < 0.001). On multivariate analysis, independent prognostic factors were TNM stage, histology, tumor site, surgical attempt, and chemotherapy (p < 0.01). Median survival for patients with palliative or adjuvant chemotherapy was 11.4 and 10.4 months, respectively, compared with +/-3 months for patients with no chemotherapy (p < 0.03). Nonsurgical patients receiving chemotherapy survived 5.4 months versus 1.1 months for those without chemotherapy. The favorable influence of chemotherapy persisted after a stratified analysis of subgroups eliminating potential biases. We identified prognostic factors for survival. Chemotherapy should be considered even for advanced-stage patients with either adjuvant or palliative attempts, because we consistently found a favorable impact on the median survival time. However, phase III prospective randomized trials are awaited.