The Prognosis Analysis Of Gastric Cancer Postoperative Concurrent Chemoradiation

Objective:1、 To explore the prognosis factors of gastric carcinoma postoperative andconcurrent chemoradiation, and analyze the influence on the prognosis of bloodtransfusion, providing reference for improving the prognosis of patients.2、To explore related factors of depression in patients with gastric cancer，and topredict depression on the survival of patients with gastric cancer.Methods:1、 The date of312patients who were diagnosed by preoperative and afteroperation from Feb.2008to Dec.2013with clinical Stage IB–III gastricadenocarcinoma in the first affiliated hospital of NanChang University wereinvestigated retrospectively,ultimately,299patients included this study，who underwent curative gastrectomy and adjuvant concurrent radiochemotherapy.Univariateanalysis was used to study the relation between the age,gender,tumor location, tumorinfiltration depth (T), lymph node metastasis number (N), TNM stages, histologicgrade, the lymph node surgery operation, chemotherapy regimens, anemia(preoperative, before chemoradiation), thrombocytosis, adjuvant therapy (bloodtransfusion, EPO, G-CSF) and the outcome of the patients by Kaplan-Meiermethod,and the log-rank test was used to compare cumulative OS between thefactors.Cox proportional hazards model was constructed to assess the effects of thetumor location,T,N,TNM stages, histologic grade,anemia (preoperative, beforechemoradiation), thrombocytosis,blood transfusion on survival.And further analyzethe effect of blood transfusion on the prognosis of patients with gastric cancer. SPSSversion21software was used for all analyses.2、The second part patients chose from the first part116patients who were werecompleted the anti-tumor treatment were included.They were assessed when alltreatment were accepted.An interview was carried out to measure depression inpatients with gastric cancert face-to-face.The researchers and patients should be serious, responsible, rigorous to complete the SDS.SPSS version21software wasused for all dates.Analysis the correlation of depressionage and gender, educationlevel, family income, medical payment,pain,tumor stage by logistic regression model.To calculate the variables’ mOS by Kaplan-Meier method.And predicted that age,gender, education level, family income, medical payment, pain, tumor location,degree of differentiation, tumor staging on the survival of patients with gastric cancerand prognosis related factors.RESULTS:1、The median survival period (OS)was46mo and3-year survival rate was79%in299patients.Univariate and multivariate analysis were used to study therelationship of the age,gender,tumor location, tumor infiltration depth (T), lymphnode metastasis number (N), TNM stage, histologic grade, the lymph node surgeryoperation, chemotherapy regimens, anemia (preoperative, before chemoradiation),thrombocytosis, adjuvant therapy (blood transfusion, EPO, G-CSF).The study showthat the age, gender,the lymph node surgery operation,chemotherapy regimens, EPO,G-CSF had no significant impact on OS. The tumor location, tumor infiltration depth(T), lymph node metastasis number (N), TNM stages, histologic grade,anemia(preoperative, before chemoradiation), thrombocytosis, blood transfusion were notonly the correlative prognosis factors but the independent prognosis factors. Patientsreceiving red blood cells transfusion had increased survival compared with patientswho receiving other blood product transfusion. The survival for the one-or-two-unitgroup was significantly different from those patients receiving more than two units ofred blood cells.2、 Family income, pain, TNM stage were the related factors affectingdepression,and age, gender, education level, medical payments has no obviousrelationship with depression of116cases.mOS of depression and no-depression groupwere respectively:46months and48months,p <0.05,The survival of the depressiongroup was poorer than not depressed patients.The depression related factors ofsurvival in patients with gastric cancer: medical payment, pain,TNM stages, P <0.05.Conclusions:1、There are many factors influence the gastric cancer patients’ prognosis who had postoperative and concurrent chemoradiation.This study conclusion that thetumor location,T,N,TNM stage, histologic grade,anemia (preoperative,beforechemoradiation), thrombocytosis,blood transfusion were the independent and suvivalharmful prognosis factors.The more blood transfusion,the worse prognosis in patents.2、Factors associated with depression were family income, pain, TNM stage,depression affect the prognosis of gastric cancer patients after postoperativechemoradiation, psychological and drug intervention in patients with depression mayimprove the survival of patients.