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胃癌根治术后并发症与远期生存的相关性分析
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Abstract:
目的：本研究旨在探讨胃癌根治术后并发症对远期生存的影响。方法：本研究回顾性分析2014年1月1日至2017年12月30日就诊于青岛大学附属烟台毓璜顶医院并施行胃癌根治术的716名胃癌患者的临床病理资料、术后并发症发生情况及术后生存情况，并根据术后并发症的发生特点进行了分组，比较了严重并发症与非严重并发症患者以及胃肠道相关并发症与非胃肠道相关并发症患者的生存曲线。结果：全部共716例患者中，术后并发症的发生率为20.5%，并根据Clavien-Dindo分级标准对术后并发症的严重程度进行分级。其中非严重并发症(I-II级)与严重并发症(III-IV级)的发生率分别为13.1%和7.4%，并且非严重并发症组的五年总生存期(OS)和无进展生存期(DFS)均优于严重并发症组(P < 0.01)。根据胃癌术后并发症分类标准将其分为胃肠道相关并发症及非胃肠道相关并发症，其中胃肠道相关并发症与非胃肠道相关并发症的发生率分别为10.7%和9.8%，并且非胃肠道相关并发症组的五年总生存期(OS)和无进展生存期(DFS)均优于胃肠道相关并发症组(P < 0.01)。进一步按照病理分期进行分层后，II期、III期患者同样观察到这种趋势。结论：胃癌根治术后严重并发症对患者5年OS和DFS均有不利影响。并发症的预防及早期诊断对手术安全和患者的长期生存至关重要。
Objective: To investigate the effect of complications after radical gastrectomy on long-term survival. Methods: This study retrospectively analyzed the clinicopathological data, postoperative complica-tions and postoperative survival of 716 patients with gastric cancer who went to Yantai Yuhuang-ding Hospital affiliated to Qingdao University from January 1, 2014 to December 30, 2017 for radi-cal gastrectomy, and grouped them according to the characteristics of postoperative complications. The survival curves of patients with severe and non-severe complications, and patients with gas-trointestinal related complications and non-gastrointestinal related complications were compared. Results: In 716 patients, the incidence of postoperative complications was 20.5%, and the severity of postoperative complications was graded according to Clavien-Dindo grading standard. The inci-dences of non-serious complications (I-II) and serious complications (III-IV) were 13.1% and 7.4%, respectively. The total five-year survival (OS) and progression free survival (DFS) of the non-serious complications group were better than those of the severe complications group (P < 0.01). According to the classification criteria of postoperative complications of gastric cancer, they were divided into gastrointestinal related complications and non-gastrointestinal related complications. The inci-dence of gastrointestinal related complications and non-gastrointestinal related complications was 10.7% and 9.8% respectively. The five-year total survival (OS) and progression free survival (DFS) of the non-gastrointestinal related complications group were better than those of the gastrointesti-nal related complications group (P < 0.01). This trend was also observed in stage II and III patients after further stratification according to pathological stages. Conclusion: Severe complications after radical gastrectomy have adverse effects on OS and DFS of patients for 5 years. The prevention and early diagnosis of
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