Abstract:
Objective To investigate the tendency of organs invaded, surgical treatment and prognosis in patients with gastric cancer. Methods The clinical data of 1580 patients with gastric cancer who received surgical treatment at the First Affiliated Hospital of Sun YatSen University from August 1994 to March 2010 were retrospectively analyzed. All patients were divided into phase 1 group (from August 1994 to December 2000), Phase 2 group (January 2001 to December 2005) and phase 3 group (January 2006 to March 2010) according to the admission time. The organs invaded, surgical modality and prognosis were compared among the 3 groups.All data were analyzed using the chisquare test or analysis of variance. The accumulative survival rates were culculated by life table. Factors might have influence on the prognosis were analyzed by the Kaplan-Meier method and Log-rank test. COX regression model was used for multifactor analysis. Results The ratios of organ invasion were 34.67%(130/375), 27.08%(117/432) and 26.65%(206/773) in phase 1, 2, 3 group respectively with significant differences (χ2=8.669, P<0.05). The ratios of single organ and 3 organs (or above) invasion were significantly decreased (χ2=6.301, 6.253, P<0.05). There was no significant change in the ratios of 2 ograns invasion (χ2=3.245, P>0.05). There were no significant differences in the ratios of pancreatic or splenic invasion among the 3 groups (χ2=1.861, 5.376, P>0.05). The ratio of pancreatic+splenic invasion increased significantly (χ2=9.404, P<0.05), and the ratio of other organs invasion decreased significantly (χ2=27.247, P<0.05). The radical resection rate of the 3 groups were 80.87%(307/375), 85.19%(368/432) and 87.71% (678/773), respectively (χ2=11.724, P<0.05). The resection rate of patients with single organ invasion was significantly increased (χ2=9.520, P<0.05). There were no significant differences among the 3 groups in the resection rate of patients with 2 or ≥3 organs invasion (χ2=3.388, 1.491, P>0.05). There were no significant differences in the resection rate of patients with pancreatic, splenic and pancreatic+splenic invasion among the 3 groups (χ2=1.843, 0.303, 1.706, P>0.05). The resection rates were significantly inceased for patients with other organs invasion (χ2=20.487, P<0.05). The 1, 3, 5year survival rates of patients in the 3 groups were significantly increased (χ2=17.879, P<0.05). The accumulative survival rates of patients with no organ or with single organ invasion in the 3 groups were significantly increased (χ2=6.147, 6.413, P<0.05). There were no significant differences in the accumulative survival time of patients with 2 organs and ≥3 organs invasion among the 3 groups (χ2=4.029, 1.274, P>0.05). There were no significant differences in the accumulative survival time of patients with pancreatic, splenic, pancreatic+splenic invasion among the 3 groups (χ2=3.608, 0.105, 2.971, P>0.05). The accumulative survival time of patients with other organs invasion were significantly increased among the 3 groups (χ2=6.749, P<0.05). Conclusion In recent 16 years, the ratio of organs invaded by gastric cancer has a downward trend, while the number of organs invaded and organs involved are imbalanced. The radical resection rate is increased and the prognosis tend to improve significantly, while the improvement of prognosis of patients with different number of organs invaded and different organs invaded is imbalanced.
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