Causes of death and recurrence after surgery for early gastric cancer
Causes of death and recurrence after surgery for early gastric cancer
复制标题
DOI：
10.1007/pl00012266
复制
发表时间：
1997-05-01
影响因子：
2.6
通讯作者：
Carboni, M
中科院分区：
文献类型：
--
作者：
Guadagni, S;Catarci, M;Carboni, M
对172例早期胃癌(EGC)患者的术后病程进行了中位7年的随访，以了解其死亡原因、复发情况、复发方式以及复发病例的特点。10年累积死亡率(+/-SE)为22+/-3.7%。7例(4.1%)死于手术死亡，11例(6.4%)死于胃癌复发，13例(7.6%)死于其他原因。非相关死因依次为异时原发癌6例，心血管疾病2例，肺炎3例，败血症1例，车祸1例。4例死于残胃复发，3例死于肝转移，2例死于淋巴结转移，2例死于腹膜扩散。COX多因素分析显示，组织学类型对复发的影响最为显著。虽然影响BG的肿瘤性质，但EGC预后相对较好。根据这项研究的结果，特别是在西方机构，切除切缘和淋巴清扫的组织学检查应该得到改进。此外，必须对晚期复发和异时性癌症的患者进行仔细的随访。
The postoperative course of 172 patients with early gastric cancer (EGC) was followed for a median 7 years to evaluate the causes of death, incidence and patterns of recurrence, and characteristic findings in the recurrent cases. The cumulative 10-year mortality rate (+/- SE) was 22 +/- 3.7%. Seven patients (4.1%) died of operative mortality, 11 (6.4%) died of a recurrence of the gastric cancer, and 13 (7.6%) died of unrelated causes. Unrelated causes of death were metachronous primary cancer (n = 6), cardiovascular disease (n = 2), pneumonia (n = 3), sepsis (n = 1), and car accident (n = 1). Four patients died from gastric stump recurrence, three from liver metastases, two from lymph node metastases, and two from peritoneal dissemination. Using Cox multivariate analysis, histologic type had the most significant effect on recurrence. Although influenced bg the tumor nature, the EGC prognosis is relatively good. Based on the results of this study, particularly in Western institutions, histologic examination of resection margins and lymphadenectomy should be improved. Moreover, patients must be carefully followed for late recurrence and metachronous cancer.