Analysis Of Factors Which Influence The Prognosis Of Gastroesophageal Junction Adenocarcinoma

Background and objective:To research and analyse the important clinicopathological and therapeutical factors affecting the prognosis of patients after gastroesophageal junction carcinoma surgery. And to provide the strong evidence for improving the prognosis and increasing the survival time.Methods:The research had collected surgical resection and the pathology inspection confirmed147cases of gastroesophageal junction carcinoma from Shandong university affiliated provincial hospital during January2006-August2007, followed up to2012over the telephone.There were114female and33female cases,which male to female ratio was3.45:1, age from29to81years old,and the median age was64. According to version7of the AJCC TNM staging, the number of0, Ⅰ, Ⅱ,Ⅲ, Ⅳ was respectively7,27,18,79,16cases. At the same time we went to the Department of pathology to collect patients’gender, age, smoking history, drinking history, TNM staging, lymph node number, lymph node metastasis status and tissue differentiation degree, whether chemotherapy, helicobacter pylori infection status, operation way so as to improved the follow-up information. By the telephone follow-up way,we acquired the5years treatments and prognosis. Refer to some professional periodicals like "Digestive Surgery ","Journal of Surgical Oncology","Chinese Journal of cancer","Journal of the Chinese general Surgery","Chinese Journal of cancer "and so on, we preliminary analysised into the plain:gender, age, smoking history, drinking history, TNM staging, lymph node clearance number, whether with or without lymph node metastasis, tumor differentiation degree, postoperative chemotherapy, etc.Using Kaplan-Meier method to process univariate analysis and utilizing the Cox regression model to process multivariate analysis.And making use of SPSS17.0for survival analysis.Results:The1years survival rate was79.3%,3years survival rate and5years survival rate was54%and40.6%respectively, median survival time was36months.5years survival rate of TNM stage0, Ⅰ, Ⅱ,Ⅲ,IVwere100%,63.0%,50.0%,63.0%and0, the median survival time is36.0months, male in patients with gastric cancer Median survival period was33.5months, while female was60.0months, Patients younger than age60with gastric cancer median survival period for60months, Greater than or equal to age60was30.5months.the clear number of lymph nodes of patients with10or more median survival was51.0months,<10patients with median survival was21.0months, with no lymph node metastasis of median survival was60.0months, with lymph node metastasis is the median survival was25.0months, postoperative chemotherapy in patients with median survival was60.0months, no chemotherapy group was26.0months, both the5-year survival rate were53.8%and34.8%respectively, smoking patients with median survival was36.0months, not smoking patients’ median survival was58.0months, drinking in patients with median survival was30.0months, not drinking in patients with median survival was58.5months.2) The single factor K-M analysis:gender (P=0.000),age (P=0.047), TNM stage (P=0.000), pathological detection lymph node number(P=0.038),lymph node status (P=0.000), tissue differentiation degree (P=0.010).chemotherapy (P=0.003) was significant correlated with the the prognosis of gastroesophageal junction carcinoma,thy were factors which influenced the prognosis.3)Using the Multiple-factor COX to analyse the above factors,we could found:TNM staging (RR1.926), chemotherapy (RR=0.525) was independent factors that affected the prognosis of gastroesophageal junction carcinoma.Conclusions: In the factors which are gender,age, TNM stage, pathological detection lymph node number,lymph node status, tissue differentiation degree,chemotherapy,we can find TNM staging is the independent risk factors of the prognosis, chemotherapy is the protective factors which is worth further study.