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Gastric Cancer:术后并发症对胃癌患者生存结局的影响

2021-01-11 MedSci原创 MedSci原创

胃癌是第五种最常见的癌症,也是世界上与癌症有关的死亡的第三大主要原因, 外科手术切除是治疗晚期胃癌的最有效的手段,但是术后并发症会对患者的生活质量产生不利影响。

      胃癌是第五种最常见的癌症,也是世界上与癌症有关的死亡的第三大主要原因, 外科手术切除是治疗晚期胃癌的最有效的手段,但是术后并发症会对患者的生活质量产生不利影响,甚至可能导致死亡,最近的研究发现术后并发症与胃癌术后患者的长期生存结果相关。虽然机理尚未完全阐明,但是很大的可能是残留的癌细胞的生长是通过手术应激或术后并发症造成的。本项研究旨在探究术后并发症对胃癌手术患者长期生存结局的影响,以及TMN分期为T3 / 4a局部晚期胃癌患者的囊肿切除术和非囊肿切除术对于生存期的影响。

 

 

      该研究纳入1191名符合标准的患者。并发症通过Clavien-Dindo(CD)分类进行分级。通过使用Cox比例风险模型进行单变量和多变量分析,最后评估了并发症的等级(≥CD等级II或≥III等级)或类型(任何或腹腔内感染)对生存结果的影响。

 

 

      研究人员发现胃癌手术后发生并发症(≥CD II级和≥III级)发生率分别为23.0%和9.7%,≥CDII级和CD≥III级腹腔内感染并发症的发生率分别为13.4%和6.9%。多变量分析显示,所有术后并发症都是整体生存的独立预后因素。相反,仅发现≥CD III级并发症是无复发生存的独立预后因素(危险比1.445;95%置信区间1.026-2.036;P = 0.035)。

 

 

      研究最后作者指出术后并发症会对cT3 / 4a胃癌患者的长期生存产生不利影响。任何≥CD III级并发症似乎都是预测阴性长期生存结果的最合适指标。

 

 

 

原始出处:

Masanori Tokunaga. Et al. Impact of postoperative complications on survival outcomes in patients with gastric cancer: exploratory analysis of a randomized controlled JCOG1001 trial. Gastric Cancer.2021.

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    2021-09-17 沈敏

    外科手术切除是治疗晚期胃癌的最有效的手段

    0

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    2021-06-29 ms4000000486455823

    学习

    0

  4. 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encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 08 09:18:35 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944166, encodeId=b23c9441667d, content=胃癌<a href='/topic/show?id=f9e2832202f' target=_blank style='color:#2F92EE;'>#胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=169, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83220, encryptionId=f9e2832202f, topicName=胃癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200818/45706d88944f4864a0fffa38b6498b6b/96f7dab5dbcf4fcfa7abc0bc766973cb.jpg, createdBy=d98f5411800, createdName=黄昏晓Time, createdTime=Sun Feb 28 12:33:49 CST 2021, time=2021-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916031, encodeId=5cc8916031ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/18/4904f1f58fd84759f4600a01d3817b4f.jpg, createdBy=f68b2548802, createdName=12539c47m51暂无昵称, createdTime=Tue Jan 12 20:45:54 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
    2021-11-24 丁鹏鹏
  5. [GetPortalCommentsPageByObjectIdResponse(id=1052187, encodeId=920c105218e9f, content=外科手术切除是治疗晚期胃癌的最有效的手段, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=afe65591083, createdName=沈敏, createdTime=Fri Sep 17 06:06:55 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769698, encodeId=27d01e69698cd, content=<a href='/topic/show?id=900b8323461' target=_blank style='color:#2F92EE;'>#胃癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83234, encryptionId=900b8323461, topicName=胃癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=377c38086944, createdName=huhuaidong400, createdTime=Sat Apr 17 11:18:35 CST 2021, time=2021-04-17, status=1, ipAttribution=), 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createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 21 15:18:35 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893699, encodeId=d57018936998e, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Tue Nov 02 13:18:35 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712665, encodeId=4b1e1e12665d6, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 08 09:18:35 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944166, encodeId=b23c9441667d, content=胃癌<a href='/topic/show?id=f9e2832202f' target=_blank style='color:#2F92EE;'>#胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=169, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83220, encryptionId=f9e2832202f, topicName=胃癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200818/45706d88944f4864a0fffa38b6498b6b/96f7dab5dbcf4fcfa7abc0bc766973cb.jpg, createdBy=d98f5411800, createdName=黄昏晓Time, createdTime=Sun Feb 28 12:33:49 CST 2021, time=2021-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916031, encodeId=5cc8916031ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/18/4904f1f58fd84759f4600a01d3817b4f.jpg, createdBy=f68b2548802, createdName=12539c47m51暂无昵称, createdTime=Tue Jan 12 20:45:54 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1052187, encodeId=920c105218e9f, content=外科手术切除是治疗晚期胃癌的最有效的手段, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=afe65591083, createdName=沈敏, createdTime=Fri Sep 17 06:06:55 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769698, encodeId=27d01e69698cd, content=<a href='/topic/show?id=900b8323461' target=_blank style='color:#2F92EE;'>#胃癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83234, encryptionId=900b8323461, topicName=胃癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=377c38086944, createdName=huhuaidong400, createdTime=Sat Apr 17 11:18:35 CST 2021, time=2021-04-17, status=1, ipAttribution=), 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createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 21 15:18:35 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893699, encodeId=d57018936998e, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Tue Nov 02 13:18:35 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712665, encodeId=4b1e1e12665d6, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 08 09:18:35 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944166, encodeId=b23c9441667d, content=胃癌<a href='/topic/show?id=f9e2832202f' target=_blank style='color:#2F92EE;'>#胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=169, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83220, encryptionId=f9e2832202f, topicName=胃癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200818/45706d88944f4864a0fffa38b6498b6b/96f7dab5dbcf4fcfa7abc0bc766973cb.jpg, createdBy=d98f5411800, createdName=黄昏晓Time, createdTime=Sun Feb 28 12:33:49 CST 2021, time=2021-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916031, encodeId=5cc8916031ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/18/4904f1f58fd84759f4600a01d3817b4f.jpg, createdBy=f68b2548802, createdName=12539c47m51暂无昵称, createdTime=Tue Jan 12 20:45:54 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
    2021-07-21 许安
  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/18/4904f1f58fd84759f4600a01d3817b4f.jpg, createdBy=f68b2548802, createdName=12539c47m51暂无昵称, createdTime=Tue Jan 12 20:45:54 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
    2021-11-02 skhzy
  8. 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  9. 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encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Feb 08 09:18:35 CST 2021, time=2021-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=944166, encodeId=b23c9441667d, content=胃癌<a href='/topic/show?id=f9e2832202f' target=_blank style='color:#2F92EE;'>#胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=169, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83220, encryptionId=f9e2832202f, topicName=胃癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200818/45706d88944f4864a0fffa38b6498b6b/96f7dab5dbcf4fcfa7abc0bc766973cb.jpg, createdBy=d98f5411800, createdName=黄昏晓Time, createdTime=Sun Feb 28 12:33:49 CST 2021, time=2021-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916031, encodeId=5cc8916031ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/18/4904f1f58fd84759f4600a01d3817b4f.jpg, createdBy=f68b2548802, createdName=12539c47m51暂无昵称, createdTime=Tue Jan 12 20:45:54 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
    2021-02-28 黄昏晓Time

    胃癌#胃癌#

    0

  10. 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    2021-01-12 12539c47m51暂无昵称

    学习了

    0

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