Evre III Gastrik Kanserli Hastalarda Postoperatif Sağkalımı Etkileyen Prognostik Faktörlerin Analizi

Amaç: Evre III mide kanserli hastalarda hastaya, tümöre ve tedaviye ilişkin prognostik faktörler ve bunların sağkalıma etkileri araştırıldı. Yöntemler: Yüz altmış üç hasta çalışmaya dahil edildi ve veriler geriye dönük olarak hastane kayıtlarından elde edildi. İncelenen parametreler; hastaya bağlı faktörler (yaş, cinsiyet, kan grubu, preoperatif hemoglobin, albumin ve serum tümör marker (karsinoembriyonik antijen (CEA), kanser antijeni 19-9 (CA 19-9) seviyeleri), tümör ilişkili faktörler (tümör lokalizasyonu, tümör boyutu) , T ve N evresi, total lenf nodu sayısı, metastatik / total lenf nodu oranı, tümörün cerrahi sınırı, patoloji, farklılaşma, lenfovasküler ve perinöral invazyon durumu) ve tedaviye bağlı faktörler (adjuvan tedavi, beslenme desteği ve kan transfüzyonu). Bulgular: 163 hastanın 52'si kadın, ortanca yaş 60 idi. Tek değişkenli analizlerde serum Ca 19-9 düzeyi (p = 0,03), serum CEA düzeyi (p = 0.01) ve lenf nodu oranı (p = 0.002) genel sağkalım ile ilişkili bağımsız bir faktör olarak bulunurken, sadece lenf nodu oranı çok değişkenli analizde etkili bir parametre idi [(p = 0.004, göreceli risk = 0.50,% 95 güven aralığı (0.32-0.80)]. Çalışma sonlandırıldığında, hastalar ortanca 16 ay boyunca takip edildi, 87 hasta (%53,4) hastalık nedeniyle öldü. Sonuç: Mide etrafındaki lenf nodlarındaki metastatik tümör yükü sağkalım üzerinde olumsuz yönde etkili olmuştur. Bu sonuç lenfatik diseksiyonun önemini göstermektedir.

Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients

Objective: In stage III gastric cancer patients who underwent resection, prognostic factors related to patient, tumor andtreatment and their survival effects were investigated.Method: One-hundred sixty three patients were included in the study and data was obtained retrospectively fromhospital records. Investigated parameters; patient-related factors (age,gender,blood group,preoperativehemoglobin,albumin and serum tumor marker (carcinoembryonic antigen(CEA), cancer antigen 19-9(CA 19-9) levels),tumor related factors (tumor localization, tumor size , T and N stage, total lymph node count, metastatic/total lymph noderatio, surgical margin of tumor, pathology, differentiation, lymphovascular and perineural invasion status) and treatmentrelated factors (adjuvant treatment, nutritional support, and blood transfusion).Results: Fifty-one out of the 163 patients were female, and the median age was 60. In univariate analysis, serum Ca19-9level (p=0,03), serum CEA level(p=0.01) and the lymph node ratio(p=0.002) were found to be an independent factorsassociated with overall survival whereas only lymph node ratio was an effective parameter in multivariate analysis[(p =0.004, relative risk =0.50, 95% confidence interval (0.32-0.80)]. When the study was finalized, patients were followed fora median of 16 months, 87 patients (53.4%) died due to the disease.Conclusion: The metastatic tumor load in the lymph nodes around the stomach was negatively effective on survival. Thisresult demonstrates the importance of lymphatic dissection.

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