胃癌术后并发症对5年生存率的影响

目的：探讨胃癌切除术后并发症的发生对患者5年生存率的影响。方法：收集2006年1月至2009年4月在我院诊断为胃腺癌且行胃癌切除术并有完整随访数据的病例380例,将其分为术后并发症组（52例）和无术后并发症组（328例）,统计术后并发症的类型及分级,以分析术后并发症发生的影响因素及术后并发症的发生对患者5年生存率的影响。结果：单因素分析显示术后并发症发生的相关因素有：年龄、体质量指数（BMI）、肿瘤浸润深度、淋巴结转移、TMN分期（P〈0.05）;单因素分析显示影响患者术后5年生存率的因素有年龄、性别、肿瘤浸润深度、淋巴结转移、远处转移、TMN分期、手术方式、肿瘤分化程度、术后并发症（P〈0.05）;COX多因素分析表明术后并发症、性别、淋巴结转移数、肿瘤分化程度是影响术后5年生存率的独立因素。结论：胃癌切除术后并发症是影响患者5年生存率的独立因素之一,积极预防和治疗术后并发症对延长患者术后生存期具有重要的意义。

The impact of postoperative complications on 5-year survival after surgery for gastric cancer

Objective： To investigate the potential impact of postoperative complications on 5-year survival after gastrectomy for gastric cancer.Methods： A total of 380 gastric cancer patients with complete follow-up data who underwent gastrectomy between January 2006 and April 2009 in the First Afifliated Hospital of Wen-zhou Medical University were enrolled in this study. Patients were devided into 2 groups： with （n=52） or without （n=328） complications after surgery. The types and classiifcations of postoperative complications were assessed to analyze the risk factors affecting the occurrence of postoperative complications and the impact of postoperative complications on 5-year survival.Results： In the univariate analysis, age, body mass index （BMI）, depth of inva-sion, lymph node metastasis, TMN staging were signiifcant predictors of postoperative complications and age, gender, depth of tumor invasion, lymph node metastasis, distant metastasis, TMN staging, surgical approach, dif-ferentiation of tumor and postoperative complications were signiifcantly related to the 5-year survival of patients （P〈0.05）. Mutivariate analysis based on COX proportional hazard regression model showed that postoperative complications, gender, lymph node metastasis and tumor differentiation were independent prognostic factors on 5-year survival.Conclusion： Postoperative complications after gastric resection is one of the independent factors in patients on 5-year survival, and active prevention and treatment of postoperative complications is of great sig-niifcance to prolong living time.