影响胃癌根治性切除术后复发的相关因素分析

目的:探讨胃癌根治性切除术后肿瘤复发的相关因素,为防治胃癌术后复发提供理论依据。方法:对已行根治性切除术的146例胃癌患者的临床资料进行回顾性分析,采用Logistic对胃癌的预后因素进行单因素和多因素回归分析。结果:有完整随访资料的患者97例,随访率66.44%(97/146)。97例根治性切除的胃癌患者中,术后1年内复发率45.4%(44/97),术后2年内复发率73.2%(71/97),2～5年期间复发率21.6%(21/97),5年后复发率4.1%(4/97);单一病灶复发的占81.5%,多部位复发的占17.3%。单因素的分析结果表明胃癌根治术后复发与肿瘤大小、原发部位、肿瘤分化程度、肿瘤分型、肿瘤浸润深度、术后是否化疗、病理分型、TNM分期有关,而与性别、年龄、手术方式无关,经过多因素回归分析结果表明肿瘤大小、辅助化疗、TNM分期为胃癌根治术后复发的独立因素。结论:胃癌根治术后复发大都出现在术后2年内,以单一复发为主;肿瘤大小、TNM分期及辅助化疗为胃癌根治术后复发的独立影响因素。

Analysis on Related Factors about Recurrence of Gastric Carcinoma after Radical Excision

Objective:To explore the factors related with recurrence of gastric carcinoma after radical excision and provide theoretical evidences for preventing from recurrence of gastric carcinoma after operation.Methods:146 patients with gastric carcinoma after radical excision were retrospectively analysized.Results:97 patients have complete follow-up data.The rate of follow-up is 66.44%(97/146).In all the 97 patients with gastric carcinoma after radical excision,the rate of recurrence in 1 year after radical excision is 45.4%(44/97),the rate of recurrence in 2 years after radical excision is 73.2%(71/97),the rate of recurrence from 2 to 5 years after radical excision is 21.6%(21/97),the rate of recurrence in 5 years after radical excision is 4.1%(4/97).The single recurrence accounts for 81.5% and the multiregional recurrence accounts for 17.3%.The monofactorially analytic results have showed that the recurrence of gastric carcinoma after radical excision correlated with the tumor size,primary region,tumor differentiation,tumor typing,tumor infiltration,presence of chemotherapy,patho-typing and TNM stage but not with sex,age and modus operandi.The multivaried logistic regression analytic results have showed that tumor size,presence of adjuvant chemotherapy and TNM stage are independent factors for recurrence of gastric carcinoma after radical excision.Conclusion:The recurrence of gastric carcinoma after radical excision develops in 2 years after operation and the most recurrence is single.The tumor size,TNM stage and presence of adjuvant chemotherapy are the independent factors that effect the recurrence of gastric carcinoma after radical excision.