目的 探讨胃癌肝转移患者的临床特征和预后的危险因素.方法 从美国国家癌症研究所监测、流行病学和最终结果(Surveillance,Epidemiology and End Results,SEER)数据库选取 2010-2015 年 7055 例胃癌患者临床资料和生存情况,根据是否发生肝转移将患者分为胃癌肝转移组(901 例)和胃癌无肝转移组(6154 例),比较两组患者的基本临床特征.采用单因素和多因素Cox回归分析胃癌肝转移患者预后的影响因素,生存分析采用Kaplan-Meier法.结果 两组患者的年龄、性别、种族、T分期、N分期、原发灶手术、放疗、肿瘤直径比较,差异均有统计学意义(P<0.05);胃癌肝转移组患者的中位生存时间为 6 个月;胃癌无肝转移组为 25 个月.Cox回归分析证实,年龄(P=0.009)、肿瘤分化程度(P<0.001)、原发灶手术(P<0.001)及化疗(P<0.001)是影响胃癌肝转移预后的危险因素.结论 年龄、肿瘤分化程度、原发灶手术和化疗是胃癌肝转移的独立预后危险因素.基于年龄、肿瘤分化程度、原发灶手术、化疗构建的生存列线图对胃癌肝转移患者具有较好的预测意义.
Analysis of prognostic factors of gastric cancer patients with liver metastases and establishment of a nomogram for survival prediction
Objective To explore the clinical features and prognostic factors of gastric cancer patients liver metastasis.Methods Data from 7055 patients with gastric cancer were retrieved from Surveillance,Epidemiology and End Results(SEER)database between 2010 and 2015.The patients were divided into the liver metastases group(901 cases)and the non-liver metastases group(6154 cases)according to whether liver metastasis occurred.Univariate and multivariate Cox regression were used to analyze the prognostic risk factors,and the Kaplan-Meier method was used for survival analysis.Results There was a significant difference in age,gender,race,T stage,N stage,primary surgery,radiotherapy and tumor size between the two groups(P<0.05),and the median survival time of patients in the liver metastases group was 6 months,non-liver metastases group was 25 months.Cox regression analysis showed that age(P=0.009),tumor grade(P<0.001),surgery(P<0.001)and chemotherapy(P<0.001)were the main factors affecting the prognosis of gastric cancer with liver metastases.Conclusion Age,tumor grade,surgery and chemotherapy were the prognostic risk factors for gastric cancer with liver metastases.A nomogram based on age,tumor grade,surgery and chemotherapy has a good survival prediction significance for gastric cancer with liver metastases.
国家科技期刊平台
NSTL
万方数据
