Study of prognostic factors in Borrmann type Ⅳ gastric cancer based on COX regression

doi:10.3877/cma.j.issn.1674-0793.2016.06.004

Abstract

Abstract:

Objective

To investigate the related prognostic factors of Borrmann type Ⅳ gastric cancer and to find out ways of improving survival rate.

Methods

The clinical data of two hundred and twenty patients with Borrmann type IV gastric cancer at Cancer Center of Sun Yat-sen University from January 2000 to December 2010 were reviewed. In total nine clinicopathologic variables such as age, sex, ascites, tumor extent, tumor size, operation type, pathological pattern, pTNM stage and comprehensive therapy were selected as observation indexes. The median survival and survival rate were estimated by the Kaplan-Meier survival curve and the log-rank test. Multivariate COX's proportional hazards regression analysis was then performed to distinguish the independent prognostic factors.

Results

The median survival time was 288 days and 1-, 3-, 5-year survival rate was 47.1%, 14.3%, 9.1%, respectively. Univariate analyses showed that age, ascites, tumor extent, tumor size, operation type and pTNM stage significantly influenced survival. Operation type and pTNM stage were regraded as the statistically significant independent risk factors associated with the prognosis of Borrmann type Ⅳ gastric cancer using Cox model (P<0.05).

Conclusion

Improving the prognosis for patients with Borrmann type Ⅳ gastric carcinoma requires early diagnosis and curative resection.

Key words: Stomach neoplasms, Prognosis, Regression analysis, Borrmann type Ⅳ

Xiaowei Sun, Wei Li, Xuechao Liu, Youqing Zhan, Zhiwei Zhou. Study of prognostic factors in Borrmann type Ⅳ gastric cancer based on COX regression[J]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(06): 401-405.

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https://zhptwkxwx.cma-cmc.com.cn/EN/Y2016/V10/I06/401

Figures/Tables 4

References 15

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变量	因素		例数	中位生存时间(d)	95% CI	Chi-Square	P值
X1	年龄（岁）		?	?	?	12.963	0.011
?	?	<30	7	92	56.073~127.927	?	?
?	?	30~40	23	356	97.749~614.251	?	?
?	?	>40~50	35	277	181.956~372.044	?	?
?	?	>50~60	62	462	264.264~659.736	?	?
?	?	>60	93	255	171.666~338.334	?	?
X₂	性别		?	?	?	1.805	0.179
?	?	男	130	333	245.206~420.794	?	?
?	?	女	90	232	145.537~318.463	?	?
X₃	腹水		?	?	?	29.363	0.000
?	?	无	142	388	306.991~469.009	?	?
?	?	有	78	103	66.690~139.310	?	?
X₄	肿瘤波及范围		?	?	?	35.724	0.000
?	?	一个分区	46	526	361.690~690.310	?	?
?	?	两个分区	68	308	195.157~420.843	?	?
?	?	全胃	106	215	153.839~276.161	?	?
X5	肿瘤大小(cm)		?	?	?	5.203	0.023
?	?	≤8	68	388	204.673~571.327	?	?
?	?	>8	152	240	168.770~311.230	?	?
X6	手术方式		?	?	?	88.666	0.000
?	?	根治切除	83	561	403.532~718.468	?	?
?	?	姑息切除	65	356	285.300~426.700	?	?
?	?	未切除	72	84	72.566~95.434	?	?
X7	分化程度		?	?	?	0.482	0.448
?	?	中-高	59	378	106.655~649.345	?	?
?	?	低-未	161	288	233.684~342.316	?	?
X₈	pTNM分期		?	?	?	78.712	0.000
?	?	Ⅱ	10	1 486	565.408~2406.592	?	?
?	?	Ⅲ	47	473	332.681~613.319	?	?
?	?	Ⅳ	144	182	120.684~243.316	?	?
X₉	综合治疗		?	?	?	1.779	0.411
?	?	无	130	242	150.788~333.212	?	?
?	?	有	90	314	243.342~384.658	?	?

变量	因素		例数	中位生存时间(d)	95% CI	Chi-Square	P值
X1	年龄（岁）		?	?	?	12.963	0.011
?	?	<30	7	92	56.073~127.927	?	?
?	?	30~40	23	356	97.749~614.251	?	?
?	?	>40~50	35	277	181.956~372.044	?	?
?	?	>50~60	62	462	264.264~659.736	?	?
?	?	>60	93	255	171.666~338.334	?	?
X₂	性别		?	?	?	1.805	0.179
?	?	男	130	333	245.206~420.794	?	?
?	?	女	90	232	145.537~318.463	?	?
X₃	腹水		?	?	?	29.363	0.000
?	?	无	142	388	306.991~469.009	?	?
?	?	有	78	103	66.690~139.310	?	?
X₄	肿瘤波及范围		?	?	?	35.724	0.000
?	?	一个分区	46	526	361.690~690.310	?	?
?	?	两个分区	68	308	195.157~420.843	?	?
?	?	全胃	106	215	153.839~276.161	?	?
X5	肿瘤大小(cm)		?	?	?	5.203	0.023
?	?	≤8	68	388	204.673~571.327	?	?
?	?	>8	152	240	168.770~311.230	?	?
X6	手术方式		?	?	?	88.666	0.000
?	?	根治切除	83	561	403.532~718.468	?	?
?	?	姑息切除	65	356	285.300~426.700	?	?
?	?	未切除	72	84	72.566~95.434	?	?
X7	分化程度		?	?	?	0.482	0.448
?	?	中-高	59	378	106.655~649.345	?	?
?	?	低-未	161	288	233.684~342.316	?	?
X₈	pTNM分期		?	?	?	78.712	0.000
?	?	Ⅱ	10	1 486	565.408~2406.592	?	?
?	?	Ⅲ	47	473	332.681~613.319	?	?
?	?	Ⅳ	144	182	120.684~243.316	?	?
X₉	综合治疗		?	?	?	1.779	0.411
?	?	无	130	242	150.788~333.212	?	?
?	?	有	90	314	243.342~384.658	?	?

协变量	回归系数	相对风险度	95% CI	Wald值	P值
手术方式	0.795	2.215	1.799~2.727	56.227	0.000
pTNM分期	0.081	1.084	1.003~1.173	4.099	0.043

协变量	回归系数	相对风险度	95% CI	Wald值	P值
手术方式	0.795	2.215	1.799~2.727	56.227	0.000
pTNM分期	0.081	1.084	1.003~1.173	4.099	0.043

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