胃癌根治术后早期复发转移的危险因素分析

背景与目的：目前胃癌仍是癌症死亡的重要原因，其术后复发是导致胃癌患者生存率较低的主要因素。本研究旨在探讨胃癌患者术后早期、晚期复发转移与临床病理学特征的关系，以便更好地改善胃癌预后。方法：回顾性分析2014年1月—2016年1月在浙江省肿瘤医院行胃癌根治性手术后出现复发转移的188例胃癌患者的临床病理学资料，比较早期复发转移患者（≤2年）与晚期复发转移患者（>2年）的临床病理学特征的差异。结果：188例患者中，126例患者出现早期复发，62例患者出现晚期复发，总体中位复发时间为术后18个月。复发部位、淋巴结转移、浆膜浸润、无术前新辅助化疗、无术后辅助化疗及低分化是胃癌术后早期复发的独立危险因素。结论：复发部位、术前新辅助化疗、术后辅助化疗、淋巴结转移、浸润深度及组织分化程度与术后复发有关。

Analysis of risk factors of early recurrence and metastasis after radical resection of gastric cancer

Background and purpose: At present, gastric cancer is still an important cause of cancer death, and its postoperative recurrence is the main factor leading to the low survival rate of gastric cancer. The purpose of this study was to investigate the relationship between early and late postoperative recurrence and metastasis and clinicopathological features in patients with gastric cancer in order to improve the prognosis of gastric cancer. Methods: The clinicopathological data of 188 patients with recurrent and metastatic gastric cancer after radical operation in Zhejiang Cancer Hospital from January 2014 to January 2016 were analyzed retrospectively. The clinicopathological characteristics of patients with early recurrence and metastasis (≤2 years) and late recurrence and metastasis (>2 years) were compared. Results: Among the 188 patients, 126 patients had early recurrence and 62 patients had late recurrence. The overall median time of recurrence was 18 months after operation. Recurrence site, lymph node metastasis, serosa infiltration, no preoperative neoadjuvant chemotherapy, no postoperative adjuvant chemotherapy and poor differentiation are independent risk factors for early postoperative recurrence of gastric cancer. Conclusion: The location of recurrence, preoperative neoadjuvant chemotherapy, postoperative adjuvant chemotherapy, lymph node metastasis, depth of invasion and degree of tissue differentiation are related to postoperative recurrence.