科研之友
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摘要
Objective To elucidate the current diagnosis and treatment status of gastric cancer in the Chinese population based on three high volume databases.Methods Clinical and pathological data of patients who underwent gastric cancer resection with complete follow-up information between January 2000 and December 2012 from Sun Yat-sen University Cancer Center,The First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital were retrospectively analyzed.The overall survival rate was calculated by Kaplan-Meier method.The prognostic risk factors were analyzed by using Cox proportional hazards model.Results A total of 8 338 cases were enrolled into the study,including 2 977 cases (35.7％) from Sun Yat-sen University Cancer Center,3 043 cases (36.5％) from The First Affiliated Hospital of China Medical University and 2 318 cases (27.8％) from Tianjin Medical University Cancer Hospital.There were 5 852 male cases and 2 486 female cases with a ratio of 2.4:1.0.The age of patients was from 15 to 89 years old (median 59 years old).The ratio of early gastric cancer (T1NanyMO) was 11.5％ (956/8 338).There were 2 226 gastric cancer cases (26.7％) originating from the fundus and cardiac region,1 637 cases (19.6％) from the body,3739 (44.9％) cases from the antrum,and 736 cases (8.8％) from the whole stomach.The median maximal tumor diameter was (4.5 ± 2.8) cm.Based on the Lauren classification,3 448 cases (41.4％) were intestinal type and 4 890 cases (58.6％) diffuse type.A total of 1 975 cases (23.7％) and 6 363 cases (76.3％) underwent complete and subtotal gastrectomy respectively.The majority of patients (7 707 cases,92.4％) underwent radical gastric resection,while 631 cases (7.6％) palliative resection.According to AJCC/UICC seventh edition of gastric cancer TNM staging system,802 patients (9.6％) were stage Ⅰ A,735 patients (8.8％) stage Ⅰ B,695 patients (8.3％) stage Ⅱ A,1 507 patients (18.1％) stage ⅡB,1 247 patients (15.0％) stage ⅢA,1 342 patients (16.1％) stage ⅢB,1 583 patients (19.0％) stage Ⅲ C and 427 patients (5.1％) stage Ⅳ.The average number of retrieved lymph node was 21.0±13.1,in which 5 761 patients (69.1％) had more than 15 retrieved lymph nodes.The overall 1-,3-,5-and 10-year survival rates were 83.0％,56.8％,49.1％ and 43.0％ respectively.For patients receiving radical resction,the 1-,3-,5-and 10-year survival rates were 84.9％,59.5％,51.7％ and 45.3％ respectively.The overall 5-year survival rates for different stages were as follows:stage Ⅰ A 93.8％,stage Ⅰ B 80.8％,stage ⅡA 70.8％,stage ⅡB 59.6％,stage ⅢA 44.4％,stage Ⅲ B 32.9％,stage ⅢC 18.9％ and stageⅣ 10.2％.Cox regression model showed that age,tumor site,tumor size,Lauren type,T staging,N staging,M staging and number of retrieved lymph nodes were independent factors affecting the prognosis of gastric cancer patients (P =0.000).Conclusion Retrospective study on these domestic three high volume databases demonstrates the clinical and pathological characteristics of gastric cancer based on Chinese population,which is expected to stand as a ground of basic data for future clinical research.
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单位中山大学
