Analysis Of 3-year Survival Of Operable Patients With Gastric Cancer In A General Hospital In Northern Shaanxi From 2014 To 2016

Background: Gastric cancer-related deaths rank second in the world among cancerrelated deaths,with about 984000 new cases and 841000 gastric cancer-related deaths worldwide each year.Data show that the incidence of gastric cancer in China has declined by an average of 3.0% a year since 2013.however,the number of gastric cancer deaths in China accounts for about 50% of all gastric cancer deaths in the world.Among the malignant tumors in Shaanxi Province,the mortality rate of gastric cancer was 18.85 / 100000,which was the third cause of death.This series of data suggest that whether in the global or local areas,the incidence and mortality of gastric cancer are in the top three,a serious threat to human health,which must be paid attention to.The purpose of this study is to study the postoperative survival and prognostic factors of operable gastric cancer patients in a hospital in northern Shaanxi,analyze the poor prognostic factors of gastric cancer,and provide more scientific basis for postoperative adjuvant treatment.Provide a basis for early diagnosis and prevention of gastric cancer in this area,and then help policy makers to evaluate the effectiveness of health policies,and finally optimize the allocation of health resources.To improve the survival of patients with gastric cancer.Methods: A retrospective study was conducted on the patients undergoing gastric cancer surgery in the affiliated Hospital of Yan’an University from January 2014 to December 2016,and the clinical and pathological data of 432 patients who met the criteria were collected.Including sex,age,tumor location,gross classification of advanced gastric cancer(Borrmann classification),histological type,depth of invasion,postoperative pathological stage(TNM stage),lymph node metastasis,number of chemotherapy cycles,CEA,CA72-4,CA19-9,Helicobacter pylori(Hp)infection,chemotherapy regimen and survival three years after operation.The survival rate was calculated by Kaplan-Meier method,and the risk factors were screened by Log-ranktest test.Cox proportional hazard model for multivariate analysis of risk factors,P < 0.05.The difference was statistically significant to explore the impact of clinicopathological features on the postoperative 3-year survival rate.Results:1.Univariate analysis showed that the factors associated with the 3-year survival rate of patients with operable gastric cancer included Borrmann classification,CEA,CA72-4,CA19-9,depth of invasion,degree of differentiation,chemotherapy regimen,chemotherapy cycle,lymph node invasion and postoperative pathological stage.2.The factors not related to the 3-year survival rate of operable patients with gastric cancer were sex,age,pathological type,HP infection and tumor location.3.Multivariate analysis showed that the independent prognostic factors of gastric cancer patients were chemotherapy cycle,tumor location,postoperative pathological stage and CA72-4 value.Conclusion:1.The patients with operable gastric cancer in this area are still mainly male,and the lower part of the stomach,Borrmann type Ⅲ + Ⅳ,adenocarcinoma is the majority.2.The 3-year cumulative survival rate of patients with operable gastric cancer in this area was 53.6%,the median survival time was 52 months,and the average survival time was 43.55(40.86-46.24)months,with a standard error of 1.372.3.Univariate analysis showed that the factors related to the survival rate of patients with operable gastric cancer included Borrmann classification,CEA,CA72-4,CA19-9,depth of invasion,degree of differentiation,chemotherapy regimen,chemotherapy cycle,lymph node invasion and postoperative pathological staging.Among them,patients with Borrmann type Ⅳ,high level CEA,high level CA72-4,high level CA19-9 and positive lymph nodes had poor prognosis,and the deeper the depth of tumor invasion,the worse the prognosis.4.The results of COX multivariate analysis showed that the independent factors affecting the survival rate of operable patients with gastric cancer were chemotherapy cycle,tumor location,postoperative pathological stage and CA72-4 value.Among them,the prognosis of patients with more than 4 chemotherapy cycles was better than that of patients with less than 4 chemotherapy cycles.The prognosis of upper gastric cancer is worse than that of middle gastric cancer.And the later the postoperative pathological stage is,the worse the prognosis is.