不同年龄段胃癌患者卵巢转移的危险因素与预后

目的探讨不同年龄胃癌患者卵巢转移的危险因素及预后。方法回顾性分析1994年至2001年经手术治疗的345例女性胃癌患者的临床病理资料,利用Logistic回归及Cox回归分析胃癌卵巢转移的危险因素及预后因素。结果同时性卵巢癌患者22例,转移率为6.4%;根治术后卵巢转移的患者24例,2年累计卵巢转移率为8.9%(24/271)。淋巴结转移数目大于7个(相对危险度9.186,95%可信区间3.773～22.365,P<0.001)、年龄小于50岁(相对危险度6.713,95%可信区间2.633～17.115,P<0.001)是卵巢转移的独立危险因素。有35例患者行手术切除,其中位生存时间11个月,多因素分析显示根治性切除是患者生存的独立相关因素(相对危险度0.056,95%可信区间0.015～0.215,P<0.001)。结论年轻患者更容易出现卵巢转移,年龄小于50岁和淋巴结转移数目超过7个是胃癌卵巢转移的重要危险因素。其预后取决于病变是否可获根治性切除。

The risk factors and prognosis of ovarian metastasis from gastric carcinoma in patients of different ages

Objective To explore the risk factors of ovarian metastasis from gastric carcinoma in patients of different ages. Methods The clinical data of 345 consecutive female patients with gastric carcinoma undergoing surgical treatment from 1994 to 2001 were retrospectively reviewed. The risk factors for ovarian metastasis were analyzed. Results Twenty two of 345 patients had synchronous ovarian metastasis. The incidence of synchronous ovarian metastasis was 6.4%. The overall 2 year ovarian relapse rate following curative resection of gastric cancer was estimated to be 8.9%(24/271). Metastatic lymph nodes more than 7(P< 0.001) and patient age less than 50 years(P< 0.001) were independent risk factors for ovarian metastasis. Thirty five patients with ovarian metastasis underwent resection and had a median survival time of 11 months. Complete resection was strongly associated with better prognosis (P< 0.001). Conclusions Younger patients with gastric cancer have a higher incidence of synchronous and metachronous ovarian metastasis. Patient age less than 50 and metastatic lymph nodes more than 7 are important risk factors for ovarian metastasis. The prognosis of ovarian metastasis is dependent on whether the disease is localized and completely resected.