胃癌根治术后肝转移的预后分析

摘要

Objective To investigate the prognostic factors of the patients with hepatic metastases from gastric cancer after radical gastrectomy.Methods In a retrospective study,the clinical data for 47 patients with hepatic metatases from gastric cancer after radical gastrectomy from January 2002 to January 2012 was investigated.Kaplan-Meier analysis was used to estimate the overall survival(OS).Cox proportional-hazards regression model was employed to analyze the prognostic factors.Results The median OS of 47patients with hepatic metastases from gastric cancer after radical gastrectomy was 26.0 months.The 1-,2-,3-,5-year survival rates were 87.5％,57.5％,22.5％ and 6.4％,respectively.Single-variable analysis showed that age,gender,tumor stage,the number of hepatic metastases,maximum diameter of hepatic metastases,treatment of hepatic metastases,the number of distant metastases,chemotherapy and the time from operation to hepatic metastases were related to OS.Cox proportional-hazards regression model showed that age,gender,tumor stage,the number of hepatic metastases and the treatment of hepatic metastases were independent factors influencing OS.Conclusion The female patients with old age,advanced tumor stage,hepatic metastases with maximum diameter≥5cm have a poor prognosis.Local treatment combined with systematic chemotherapy may prolong OS.%目的 探讨影响胃癌根治术后肝转移患者预后的相关因素.方法 收集2002年1月至2012年1月47例胃癌根治术后肝转移患者的临床资料,采用Kaplan-Meier法行单因素生存分析,Cox比例风险模型对影响预后的因素行多因素分析.结果 47例胃癌根治术后肝转移患者的中位生存期为26.0个月,1、2、3、5年生存率分别为87.5％、57.5％、22.5％和6.4％；单因素分析显示年龄、性别、胃癌术后分期、肝内转移灶数目、肝转移灶最大直径、肝外转移灶数目、肝转移治疗方式、手术至肝转移的时间和化疗情况对生存期有影响；Cox多因素分析显示,性别、年龄、胃癌术后分期、肝转移灶最大直径和肝转移治疗方式为影响生存期的独立因素.结论 老年、女性、胃癌术后分期较晚及肝转移灶直径较大者预后不良,采用局部治疗联合全身化疗可延长患者生存期.