Prognostic factors in patients with loco-regionally advanced gastric cancer.
Prognostic factors in patients with loco-regionally advanced gastric cancer.
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DOI：
10.1186/s12957-017-1243-z
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发表时间：
2017-09-15
影响因子：
3.2
通讯作者：
Mahteme H
中科院分区：
文献类型：
--
作者：
Hultman B;Gunnarsson U;Nygren P;Sundbom M;Glimelius B;Mahteme H
本研究的目的是调查与局部-区域晚期胃癌（GC）治疗相关的流行病学和预后因素。2000年至2009年间，在乌普萨拉县发现了255名胃癌患者。在初次诊断或随访期间，分析局部区域晚期胃癌的患者记录，胃癌定义为累及腹膜的肿瘤，不包括原发肿瘤的浆膜侵犯。还分析了远处转移（DM）的存在与否，包括血液转移（如肝、肺和骨）和/或远处淋巴结转移。采用Cox比例风险模型对影响生存率的因素进行多因素分析。120名患者（占所有GC患者的47%，中位年龄70.5岁）患有局部-区域晚期疾病，对应于每10万人年3.8例的发病率。其中41%同时患有糖尿病。从诊断为局部区域晚期疾病开始，总患者队列的中位总生存期（mOS）为4.8个月，非糖尿病患者亚组为5.1个月，糖尿病患者亚组为4.7个月。同步和非同步局部区域晚期胃癌亚组之间的mOS无显著差异：4.8个月（范围0 - 67.4）对4.7个月（范围0 - 28.3）。通过多变量Cox分析，生存的积极预后因素是在诊断和姑息性化疗和/或放疗的治疗中表现良好。同时性糖尿病是一个不良预后因素。2000-2004年期间（5.1个月，范围0-67.4）与2005-2009年期间（4.0个月，范围0 - 28.3）比较，最高生存指数没有差异。在这项研究中，几乎一半的胃癌患者发生腹膜受累，并与预期寿命短有关。新的治疗策略是必要的。
The aim of this study was to investigate epidemiologic and prognostic factors relevant to the treatment of loco-regionally advanced gastric cancer (GC). Two hundred and fifty-five patients with GC were identified in Uppsala County between 2000 and 2009. Patient records were analyzed for loco-regionally advanced GC defined as tumor with peritoneal involvement, excluding serosal invasion from the primary tumor only, at primary diagnosis or during follow-up. The presence or not of distant metastasis (DM), including hematogenous metastases (e.g., liver, lung, and bone) and/or distant lymph node metastases, was also analyzed. The Cox proportional hazard model was used for multivariate analysis of factors influencing survival. One hundred and twenty patients (47% of all patients with GC; median age 70.5 years) had loco-regionally advanced disease, corresponding to an incidence of 3.8 per 100,000 person-years. Forty-one percent of these also had DM. Median overall survival (mOS) from the time of the diagnosis of loco-regionally advanced disease was 4.8 months for the total patient cohort, 5.1 months for the subgroup of patients without DM, and 4.7 months for the subgroup with DM. There was no significant difference in mOS between the subgroups with synchronous versus metachronous loco-regionally advanced GC: 4.8 months (range 0.0–67.4) versus 4.7 months (range 0.0–28.3). Using multivariate Cox analysis, positive prognostic factors for survival were good performance status at diagnosis and treatment with palliative chemotherapy and/or radiotherapy. Synchronous DM was a negative prognostic factor. The mOS did not differ when comparing the time period 2000–2004 (5.1 months, range 0–67.4) with the period 2005–2009 (4.0 months, range 0.0–28.3). Peritoneal involvement occurred in almost half of the patients with GC in this study and was associated with short life expectancy. New treatment strategies are warranted.
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影响因子：
2.5
作者：
Chen, Shi;Li, Yuan-Fang;Chen, Ying-Bo
通讯作者：
Chen, Ying-Bo
影响因子：
3.7
作者：
Karpeh, MS;Brennan, MF
通讯作者：
Brennan, MF
DOI：
10.1016/0960-7404(92)90034-i
发表时间：
1992-10-01
期刊：
Surgical oncology
影响因子：
--
作者：
Moriguchi, S;Maehara, Y;Nose, Y
通讯作者：
Nose, Y
影响因子：
254.7
作者：
Parkin, DM;Bray, F;Pisani, P
通讯作者：
Pisani, P
影响因子：
3.7
作者：
Glehen, Olivier;Gilly, Francois Noel;Elias, Dominique
通讯作者：
Elias, Dominique