胃癌术后并发症对5年生存率的影响

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摘要目的：探讨胃癌切除术后并发症的发生对患者5年生存率的影响。方法：收集2006年1月至2009年4月在我院诊断为胃腺癌且行胃癌切除术并有完整随访数据的病例380例，将其分为术后并发症组（52例）和无术后并发症组（328例），统计术后并发症的类型及分级，以分析术后并发症发生的影响因素及术后并发症的发生对患者5年生存率的影响。结果：单因素分析显示术后并发症发生的相关因素有：年龄、体质量指数（BMI）、肿瘤浸润深度、淋巴结转移、TMN分期（P＜0.05）；单因素分析显示影响患者术后5年生存率的因素有年龄、性别、肿瘤浸润深度、淋巴结转移、远处转移、TMN分期、手术方式、肿瘤分化程度、术后并发症（P＜0.05）；COX多因素分析表明术后并发症、性别、淋巴结转移数、肿瘤分化程度是影响术后5年生存率的独立因素。结论：胃癌切除术后并发症是影响患者5年生存率的独立因素之一，积极预防和治疗术后并发症对延长患者术后生存期具有重要的意义。

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	马海广
	胡畅远
	庞文洋
	金劲激
	陈娇珍
	金灿灿
	陈文静
	朱冠保

关键词 ：胃肿瘤, 手术后并发症, 5年生存率

Abstract：Objective: To investigate the potential impact of postoperative complications on 5-year survival after gastrectomy for gastric cancer. Methods: A total of 380 gastric cancer patients with complete follow-up data who underwent gastrectomy between January 2006 and April 2009 in the First Affiliated Hospital of Wenzhou Medical University were enrolled in this study. Patients were devided into 2 groups: with (n=52) or without (n=328) complications after surgery. The types and classifications of postoperative complications were assessed to analyze the risk factors affecting the occurrence of postoperative complications and the impact of postoperative complications on 5-year survival. Results: In the univariate analysis, age, body mass index (BMI), depth of invasion, lymph node metastasis, TMN staging were significant predictors of postoperative complications and age, gender, depth of tumor invasion, lymph node metastasis, distant metastasis, TMN staging, surgical approach, differentiation of tumor and postoperative complications were significantly related to the 5-year survival of patients (P<0.05). Mutivariate analysis based on COX proportional hazard regression model showed that postoperative complications, gender, lymph node metastasis and tumor differentiation were independent prognostic factors on 5-year survival. Conclusion: Postoperative complications after gastric resection is one of the independent factors in patients on 5-year survival, and active prevention and treatment of postoperative complications is of great significance to prolong living time.

Key words： gastric neoplasms postoperative complications 5-year survival

收稿日期: 2014-08-07

基金资助:浙江省自然科学基金资助项目（Y2100660）。

通讯作者: 朱冠保，教授，主任医师，硕士生导师，Email：zgbwmc@126.com。

作者简介: 马海广（1988-），男，浙江温州人，硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2014/V44/I11/787

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