癌症根治性胃切除术后T1期II期患者生存率差。

IF 3.2 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastric Cancer Pub Date : 2023-10-01 DOI:10.5230/jgc.2023.23.e40

Hayemin Lee, Kyo Young Song, Han Hong Lee, Junhyun Lee

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引用次数: 0

摘要

目的：淋巴结（LN）转移是癌症（GC）患者预后的关键因素，已知在T期晚期患者中更常见。本研究旨在分析T1胃癌中晚期LN转移患者的生存数据。材料和方法：2008年1月至2018年6月，677例病理II期胃癌患者接受根治性胃切除术，分为早期胃癌组（EG:T1N2和T1N3a，n=103）和晚期胃癌组（AG:T2N1、T2N2、T3N0、T3N1和T4aN0，n=574）。比较两组患者的短期和长期生存率。结果：EG组和AG组分别有80.6%（n=83）和52.8%（n=303）的患者患有IIA期AGC。两组间淋巴结剥离的程度、回收淋巴结的数量以及短期发病率和死亡率没有差异。所有患者的5年无复发生存率（RFS）为87.8%，总生存率为84.0%。EG组的RFS低于AG组（82.2%对88.7%，P=0.047）。这种差异在IIA期患者中更为明显（82.4%对92.9%，P=0.003）相同级别。强烈建议这些患者进行辅助化疗，未来的分期系统可能需要直立的T1N2期肿瘤。

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Worse Survival of Patients With T1 Stage II Gastric Cancer Following Radical Gastrectomy.

Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC.

Materials and methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups.

Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003).

Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

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来源期刊

Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research

CiteScore

4.30

自引率

12.00%

发文量

期刊介绍： The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.