胃腺癌患者转移部位对预后的影响

目的探讨远处转移部位与胃腺癌患者预后的关系。 方法利用美国SEER数据库中2010年1月至2014年12月间诊断为胃腺癌伴远处转移的病例，Kaplan Meier法绘制生存曲线，采用Cox比例风险回归模型分析影响总生存、肿瘤特异性生存的独立因素。 结果共6532例病例纳入本研究，其中骨转移784例、脑转移126例、肝转移2692例、肺转移958例和远处淋巴结转移2321例。单器官转移患者中，骨转移者较肝转移者的总生存、肿瘤特异性生存差；远处淋巴结转移者较骨转移、肝转移、肺转移、脑转移者的总生存、肿瘤特异性生存好。Cox多因素分析表明，在已发生远处转移的胃腺癌患者中，男性、高龄、未婚、低分化、未行原发灶手术或多器官转移者的总生存和肿瘤特异性生存均较差。 结论不同转移部位对胃癌患者预后的影响不尽相同。在单器官转移的胃腺癌患者中，骨转移患者较肝或远处淋巴结转移者的预后差。对于胃腺癌伴远处转移的患者，男性、高龄、未婚、低分化、未行原发灶手术或多器官转移是影响预后的独立危险因素。

ffect analysis of metastatic site on the prognosis of gastric adenocarcinoma#br# #br#

ObjectiveTo investigate the relationship between the site of distant metastases and the prognosis of patients with gastric adenocarcinoma. MethodsCases of gastric adenocarcinoma with distant metastasis diagnosed from January 2010 to December 2014 in the US SEER database were chosen. The survival curves were drawn by Kaplan Meier method， and the independent prognostic factors of overall survival and cancer specific survival were analyzed by Cox proportional hazards regression model. ResultsA total of 6532 cases were enrolled in this study, including 784 cases of bone metastases, 126 cases of brain metastases, 2692 cases of liver metastases, 958 cases of lung metastases and 2321 cases of distant lymph node metastases. In patients with single organ metastases， overall survival and cancer specific survival of patients with bone metastases were poorer than those with liver metastases； overall survival and cancer specific survival of patients with distant lymph node metastases were better than those with bone metastases， liver metastases， lung metastases and brain metastases. Cox multivariate analysis showed that in patients with distant metastasis of gastric adenocarcinoma， the overall survival and cancer specific survival were poor in men， elderly， unmarried， poorly differentiated， without primary surgery or multiple organ metastasis. ConclusionDifferent metastatic sites have different effects on the prognosis of patients with gastric cancer. In patients with single organ metastasis of gastric adenocarcinoma， patients with bone metastases have poorer prognosis than those with liver metastases or distant lymph node metastases. For patients with gastric adenocarcinoma with distant metastasis， male， venerable age， unmarried， low differentiation， non primary surgery or multiple organ metastasis were the risk factors for prognosis.