Cox Regression Analysis of Factors Influencing Postoperative Survival Rate of Gastric Cancer Patients ._CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HAN Fanghai ¹ , ZHAN Wenhua ² , ZHANG Zhaoda ¹ , HE Yulong ² , ZHOU Xiang ¹

Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Gastric cancer Survival rate Influential factor Cox regression analysis

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【Abstract】ObjectiveTo study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients’ survival rate.
MethodsFrom Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Logrank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4－131 months.
ResultsSingle factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.
ConclusionIndependent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.

Citation： HAN Fanghai,ZHAN Wenhua,ZHANG Zhaoda,HE Yulong,ZHOU Xiang. Cox Regression Analysis of Factors Influencing Postoperative Survival Rate of Gastric Cancer Patients .. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(1): 29-33下转37. doi: Copy

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1. Hartgrink HH, van de Velde CJ. Status of extended lymph node dissection: locoregional control is the only way to survive gastric cancer [Ｊ]. J Surg Oncol， 2005; 90(3)∶153.
2. 陈峻青. 胃肠外科学 \[A\] .见：王吉甫主编. 胃癌 \[M\]. 第1版. 北京：人民卫生出版社， 2000∶360～397.
3. Kranenbarg EK, van de Velde CJ. Gastric cancer in the elderly [Ｊ]. Eur J Surg Oncol， 1998; 24(5)∶384.
4. Sasako M. Risk factors for surgical treatment in the Dutch Gastric Cancer Trial [Ｊ]. Br J Surg， 1997; 84(11)∶1567.
5. 詹文华. 胃近、远端癌临床疗效差异的评价 [Ｊ]. 中国普通外科杂志， 2002; 11（4）∶ 193.
6. 刘统成，詹文华. 早期胃癌病理特点的认识及手术治疗的新进展 [Ｊ]. 中华胃肠外科杂志， 1999； 2（1）∶ 61.
7. 何裕隆，陈创奇，郑章清，等. 胃癌侵犯或累及胰十二指肠区域的手术治疗选择 [Ｊ]. 中国实用外科杂志， 2000; 20（11）∶658.
8. Furukawa H, Hiratsuka M, Iwanaga T. A rational technique for surgical operation on Borrmann type 4 gastric carcinoma: left upper abdominal evisceration plus Appleby’s method [Ｊ]. Br J Surg， 1988; 75(2)∶116.
9. Degiuli M, Sasako M, Calgaro M, et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial [Ｊ]. Eur J Surg Oncol， 2004; 30(3)∶303.
10. McCulloch P, Nita ME, Kazi H, et al. Extended versus limited lymph nodes dissection technique for adenocarcinoma of the stomach [Ｊ]. Cochrane Database Syst Rev， 2003; (4)∶CD001964.
11. Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial [Ｊ]. J Clin Oncol, 2004; 22(11)∶2069.
12. Cuschieri A, Weeden S, Fielding J, et al. Patient survival after D1 and D2 resections for gastric cancer: longterm results of the MRC randomized surgical trial. Surgical Cooperative Group [Ｊ]. Br J Cancer, 1999; 79(9-10)∶1522.
13. 太田惠一郎，大山繁和，高橋孝，他. 胃癌手術の历史的変遷 [Ｊ]. 消化器外科， 1999； 22（7）∶1175.
14. Sano T, Sasako M, Yamamoto S, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended paraaortic lymphadenectomy——Japan Clinical Oncology Group study 9501 [Ｊ]. J Clin Oncol, 2004; 22(14)∶2767.
15. Bunt AM, Hermans J, Boon MC, et al. Evaluation of the extent of lymphadenectomy in a randomized trial of Western versus Japanesetype surgery in gastric cancer [Ｊ]. J Clin Oncol, 1994; 12(2)∶417.
16. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of the stomach. A patient care study by the American College of Surgeons [Ｊ]. Ann Surg, 1993; 218(5)∶58317McCulloch P. Should general surgeons treat gastric carcinoma? An audit of practice and results, 1980-1985 [Ｊ]. Br J Surg, 1994; 81(3)∶417.
17. Bonenkamp JJ, van de Velde CJ, Kampschoer GH, et al. Comparison of factors influencing the prognosis of Japanese, German, and Dutch gastric cancer patients [Ｊ]. World J Surg, 1993; 17(3)∶410.
18. Kaneda M, Horimi T, Ninomiya M, et al. Adverse affect of blood transfusions on survival of patients with gastric cancer [Ｊ]. Transfusion, 1987; 27(5)∶375.
19. Eroglu A, Canpinar H, Kansu E. Influence of perioperative whole blood transfusions on lymphocyte subpopulations in patients with stage Ⅱ breast cancer [Ｊ]. Med Oncol, 1999; 16(1)∶53.
20. Blumberg N, Heal J, Chuang C, et al. Further evidence supporting a cause and effect relationship between blood transfusion and earlier cancer recurrence [Ｊ]. Ann Surg, 1988; 207(4)∶410.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Cox Regression Analysis of Factors Influencing Postoperative Survival Rate of Gastric Cancer Patients .

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