The Analysis Of Prognostic Factors For 643 Patients With Gastric Cancer

Objective:To investigate the prognosis factors of gastric cancer patients who underwent operations.Methods:643 cases of patients with gastric cancer were treated surgically in the 1st affiliated hospital of Guangxi medical university from January 1,1997 to January 31,2006.The prognosis was studied by univariate survival analysis.Results:Of the 643 cases,the 1-,3- and 5- year overall survival rate was 50%,32%and 23%,respectively.The age ranged from 18 to 87 years,mean age was 54.5 years,median age was 56 years,male to female rario was 2.3:1. Survival analysis showed that gender was not associated with prognosis (P=0.348＞0.05),age was associated with prognosis(P=0.003＜0.05).Tumor location was associated with prognosis(P＜0.05),the prognosis was the best in patients with tumor located in lower stomach.Tumor size was associated with prognosis(P＜0.05),the bigger the tumor size,the poorer the prognosis; Borrmann types was associated with prognosis(P＜0.05),the prognosis ofⅡ-type was the best,the prognosis ofⅣ-type was the poorest.Pathology types was associated with prognosis(P＜0.05),the prognosis of poorly differentiated adenocarcinoma was the poorest,the next was signet-ring cell carcinoma,there were no significantly differences in other types.Tumor invasion depth was associated with prognosis(P＜0.05),the deeper the tumor invasion,the poorer the prognosis.Lymph nodes metastasis was associated with prognosis(P＜0.05), the more the metastatic lymph nodes,the poorer the prognosis.All patients were undergone operation,446 patients were undergone radical excision, radical resection rate was 69.4%,of which D1 were 25 cases,D2 were 397 cases, D3 were 24 cases.There were 36 patients undergone combined resection of invaded adjacent organ in the resection cases.There were 102 patients who were undergone palliative resection.And 46 patients were undergone gastrojejunostomy,49 cases were undergone exploratory laparotomy.Survival analysis showed that type of operation and the extent of radical was associated with prognosis(P values were＜0.05),the prognosis of radical excision was better than palliative operation.In radical excision cases,the prognosis of D1 was better than D2 and D3 In palliative operation cases,the prognosis of palliative resection was better than non-resection.In non-resection cases,the prognosis of gastrojejunostomy was better than exploratory laparotomy.In tumour stage(TNM-staging),Ⅰ-stage occupyed a very small proportion,only 7%Most of all wereⅢ-stage which were accounted for 52.7%.In this study,I A were 19 cases(3%),I B were 26 cases(4%),Ⅱwere 117 cases(18%),ⅢA were 148 cases(23%),ⅢB were 191 cases(30%),Ⅳwere 142 cases(22%).Survival analysis showed that TNM-staging was associated with prognosis(P＜0.05),the higher the TNM-staging,the poorer the prognosis.Conclusion:Age,tumor size,tumor location,Borrmann types,depth of invasion,pathology types,lymph node metastasis and TNM staging were the prognosis factors of gastric cancer.To improve the survival rate of gastric cancer, surgical treatment was effective procedure for gastric cancer and curative resection is the best of all therapies.