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目的:对晚期胃癌一线化疗后接受手术治疗的患者进行分析,寻找影响该组患者生存的因素。方法:回顾性分析2007年8月至2011年7月32例一线化疗后接受手术治疗的晚期胃癌患者的资料,分析多种临床病理因素对生存的影响。生存分析采用Kaplan-Meier法,并以Log-rank法比较组间差异,应用Cox模型进行多因素分析。结果:全组患者中位年龄46岁(22~74岁),中位生存期为19个月(4~59个月)。生存分析显示化疗疗效(PR,SD患者分别为23个月和14.5个月,P=0.045)和原发灶是否切除(切除,未切除患者分别为23个月和5.5个月,P=0.017)与总生存相关。多因素分析未显示单一的因素与患者的生存相关。结论:化疗有效、原发病灶可切除的经过选择的晚期胃癌患者,可以尝试进行原发病灶的手术治疗。
OBJECTIVE: To analyze the patients who underwent surgery after first-line chemotherapy for advanced gastric cancer and find out the factors influencing the survival of this group of patients. Methods: The data of 32 patients with advanced gastric cancer undergoing primary surgery after first-line chemotherapy between August 2007 and July 2011 were retrospectively analyzed. The effects of various clinicopathological factors on the survival were analyzed. Survival analysis using Kaplan-Meier method, and Log-rank method to compare differences between groups, using Cox model for multivariate analysis. Results: The median age of all patients was 46 years (22-74 years) with a median survival of 19 months (range 4-59 months). Survival analysis showed that the efficacy of chemotherapy (23 months and 14.5 months, respectively, P = 0.045) and primary resection in patients with PR and SD (23 and 5.5 months after resection and without resection, respectively, P = 0.017) Related to overall survival. Multivariate analysis did not show a single factor associated with patient survival. Conclusion: Chemotherapy is effective, the primary lesion can be resected after the selected patients with advanced gastric cancer, you can try the primary lesion surgery.