AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer an...AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer and compared it with the Cox model.Three thousand and eighteen gastric cancer patients who received a gastrectomy between 1980 and 2004 were retrospectively evaluated.Clinic-pathological factors were included in a log-normal model as well as Cox model.The akaike information criterion (AIC) was employed to compare the efficiency of both models.Univariate analysis indicated that age at diagnosis,past history,cancer location,distant metastasis status,surgical curative degree,combined other organ resection,Borrmann type,Lauren's classification,pT stage,total dissected nodes and pN stage were prognostic factors in both log-normal and Cox models.RESULTS:In the final multivariate model,age at diagnosis,past history,surgical curative degree,Borrmann type,Lauren's classification,pT stage,and pN stage were significant prognostic factors in both log-normal and Cox models.However,cancer location,distant metastasis status,and histology types were found to be significant prognostic factors in log-normal results alone.According to AIC,the log-normal model performed better than the Cox proportional hazard model (AIC value:2534.72 vs 1693.56).CONCLUSION:It is suggested that the log-normal regression model can be a useful statistical model to evaluate prognostic factors instead of the Cox proportional hazard model.展开更多
Objective： In advanced gastric carcinomas that have invaded adjacent organs, the prognosis is poor. When combined resections are performed in T4 gastric cancers, it is inconclusive as to whether or not there is an im...Objective： In advanced gastric carcinomas that have invaded adjacent organs, the prognosis is poor. When combined resections are performed in T4 gastric cancers, it is inconclusive as to whether or not there is an improvement in the survival rate. We compared with gastrectomy alone to analyze the prognostic factors in T4 gastric cancers. Methods： Between January 1997 and December 2004, 115 patients underwent surgery for T4 gastric cancer; we divided them into two groups： combined resections in group Ⅰ, gastrectomy alone in group Ⅱ. Surgical outcomes and clinicopathologic factors were compared and prognostic factors were evaluated. Results： Among the two groups, statistically significantly different factor was Borrmann type. The most commonly resected organ was the transverse colon, and no one post-operative morbidities developed. In the multivariate analysis, the treatment group and curability were proved to be independent prognostic factors. Conclusion： In patients with T4 gastric carcinoma, surgical gastrectomy alone approach can be beneficial. Compared with the group I, non-resection （gastrectomy alone） can be performed for a better surgical approach.展开更多
Objective:The aim of our study was to identify clinicopathological characteristics as predictive factors for gastric cancer tumours of less than 2 cm in diameter.Methods:The clinicopathological features of 129 patient...Objective:The aim of our study was to identify clinicopathological characteristics as predictive factors for gastric cancer tumours of less than 2 cm in diameter.Methods:The clinicopathological features of 129 patients with gastric cancer tumour of less than 2 cm in diameter were reviewed retrospectively from hospital records between 1980 and 2000.The results of retrospective analysis of clinicopathological data of 58 patients with advanced cancer were compared with those of 71 patients with early cancer.Univariate and multivariate analyses of patients with gastric cancer tumours were performed to evaluate the prognostic significance of clinicopathological features.Results:Lymph-node metastasis was found more frequently in the advanced cancer group than in the early cancer group.In univariate analysis,unfavorable prognostic factors included deep cancer invasion.Using Cox's proportional hazard regression model,only depth of invasion emerged as an independent statistically significant prognostic parameter associated with long-term survival.Conclusion:Depth of invasion is an independent prognostic factor for gastric cancer tumours of less than 2 cm in diameter.Laparoscopic surgery should not be performed on tumours that are diagnosis in advanced stage and lymph-node involvement.We recommend laparoscopic surgery involving local resection of the stomach without lymphadenectomy for small,early gastric cancer tumours.However,the validity of this recommendation should be tested by a prospective randomized control trial in the future.展开更多
基金Supported by the Gastric Cancer Laboratory and Pathology Department of Chinese Medical University,Shenyang,Chinathe Science and Technology Program of Shenyang,No. 1081232-1-00
文摘AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer and compared it with the Cox model.Three thousand and eighteen gastric cancer patients who received a gastrectomy between 1980 and 2004 were retrospectively evaluated.Clinic-pathological factors were included in a log-normal model as well as Cox model.The akaike information criterion (AIC) was employed to compare the efficiency of both models.Univariate analysis indicated that age at diagnosis,past history,cancer location,distant metastasis status,surgical curative degree,combined other organ resection,Borrmann type,Lauren's classification,pT stage,total dissected nodes and pN stage were prognostic factors in both log-normal and Cox models.RESULTS:In the final multivariate model,age at diagnosis,past history,surgical curative degree,Borrmann type,Lauren's classification,pT stage,and pN stage were significant prognostic factors in both log-normal and Cox models.However,cancer location,distant metastasis status,and histology types were found to be significant prognostic factors in log-normal results alone.According to AIC,the log-normal model performed better than the Cox proportional hazard model (AIC value:2534.72 vs 1693.56).CONCLUSION:It is suggested that the log-normal regression model can be a useful statistical model to evaluate prognostic factors instead of the Cox proportional hazard model.
基金Supported by grants from (in part) National Natural Science Foundation Project (No. 30972939)Science and Technology Projects in Shenyang (No. 1071166-9-00/1071162-9-00)
文摘Objective： In advanced gastric carcinomas that have invaded adjacent organs, the prognosis is poor. When combined resections are performed in T4 gastric cancers, it is inconclusive as to whether or not there is an improvement in the survival rate. We compared with gastrectomy alone to analyze the prognostic factors in T4 gastric cancers. Methods： Between January 1997 and December 2004, 115 patients underwent surgery for T4 gastric cancer; we divided them into two groups： combined resections in group Ⅰ, gastrectomy alone in group Ⅱ. Surgical outcomes and clinicopathologic factors were compared and prognostic factors were evaluated. Results： Among the two groups, statistically significantly different factor was Borrmann type. The most commonly resected organ was the transverse colon, and no one post-operative morbidities developed. In the multivariate analysis, the treatment group and curability were proved to be independent prognostic factors. Conclusion： In patients with T4 gastric carcinoma, surgical gastrectomy alone approach can be beneficial. Compared with the group I, non-resection （gastrectomy alone） can be performed for a better surgical approach.
基金Supported by grants from the Science and Technology Program of Shenyang (No.1071166-9-00)the Science and Technology Program of Shenyang (No.1081232-1-00)
文摘Objective:The aim of our study was to identify clinicopathological characteristics as predictive factors for gastric cancer tumours of less than 2 cm in diameter.Methods:The clinicopathological features of 129 patients with gastric cancer tumour of less than 2 cm in diameter were reviewed retrospectively from hospital records between 1980 and 2000.The results of retrospective analysis of clinicopathological data of 58 patients with advanced cancer were compared with those of 71 patients with early cancer.Univariate and multivariate analyses of patients with gastric cancer tumours were performed to evaluate the prognostic significance of clinicopathological features.Results:Lymph-node metastasis was found more frequently in the advanced cancer group than in the early cancer group.In univariate analysis,unfavorable prognostic factors included deep cancer invasion.Using Cox's proportional hazard regression model,only depth of invasion emerged as an independent statistically significant prognostic parameter associated with long-term survival.Conclusion:Depth of invasion is an independent prognostic factor for gastric cancer tumours of less than 2 cm in diameter.Laparoscopic surgery should not be performed on tumours that are diagnosis in advanced stage and lymph-node involvement.We recommend laparoscopic surgery involving local resection of the stomach without lymphadenectomy for small,early gastric cancer tumours.However,the validity of this recommendation should be tested by a prospective randomized control trial in the future.
