AIM： To identify the clinicopathological characteristics of lymph node-negative gastric carcinoma, and also to evaluate outcome indicators in the lymph node-negative patients.METHODS： Of 2848 gastric carcinoma patie...AIM： To identify the clinicopathological characteristics of lymph node-negative gastric carcinoma, and also to evaluate outcome indicators in the lymph node-negative patients.METHODS： Of 2848 gastric carcinoma patients, 1524 （53.5%） were lymph nede-negative. A statistical analysis was performed using the Cox model to estimate outcome indicators. RESULTS： There was a significant difference in the recurrence rate between lymph nede-negative and lymph node-positive patients （14.4% vs 41.0%, P〈0.001）. The 5-year survival rate was significantly lower in lymph node-positive than in lymph node-negative patients （31.1% vs 77.4%, P〈0.001）. Univariate analysis revealed that the following factors influenced the 5-year survival rate： patient age, tumor size, depth of invasion, tumor location, operative type, and tumor stage at initial diagnosis. The Cox proportional hazard regression model revealed that tumor size, serosal invasion, and curability were independent, statistically significant, prognostic indicators of lymph node-negative gastric carcinoma. CONCLUSION： Lymph node-negative patients have a favorable outcome attributable to high curability, but the patients with relatively large tumors and serosal invasion have a poor prognosis. Curability is one of the most reliable predictors of long-term survival for lymph nodenegative gastric carcinoma patients.展开更多
Purpose: The development of malignancy is a life changing concern for many individuals. The classification of the tumor alone does not adequately take into consideration the patient’s physical condition. Thus, a syst...Purpose: The development of malignancy is a life changing concern for many individuals. The classification of the tumor alone does not adequately take into consideration the patient’s physical condition. Thus, a system to classify both the patient and the tumor has been followed-the ORC system. Method: Additional information regarding the patient and their health has been followed by most physicians but not systematically categorized. By using the individuals health information in addition to the TNM classification one can more adequately advise the patient. Thus O-operability, R-resectability, and C-curability are all considered and more appropriately define the patient and his/her tumor condition. Results: The patient’s physical condition must be acceptable for the treatment-whether surgical or nonsurgical. Pulmonary, cardiac, muscular, renal or other disease entities must not be so severe as to prevent treatment (operability). The lesion should be in a location and of a size to afford possible excision-resectability, and the tumor should be potentially curable in order to justify major intervention. Thus, by combining the patient’s specific health status as well as the tumor characteristics (TNM) a better clarification of the treatment, the options, and the prognosis are delineated. Conclusion: When a patient is seen with a tumor-malignant or benign, therapeutic considerations must include the individual’s health status as well as the tumor prior to determining the treatment. Therefore, a system to consider both the health and the tumor is proposed-the ORC system.展开更多
文摘AIM： To identify the clinicopathological characteristics of lymph node-negative gastric carcinoma, and also to evaluate outcome indicators in the lymph node-negative patients.METHODS： Of 2848 gastric carcinoma patients, 1524 （53.5%） were lymph nede-negative. A statistical analysis was performed using the Cox model to estimate outcome indicators. RESULTS： There was a significant difference in the recurrence rate between lymph nede-negative and lymph node-positive patients （14.4% vs 41.0%, P〈0.001）. The 5-year survival rate was significantly lower in lymph node-positive than in lymph node-negative patients （31.1% vs 77.4%, P〈0.001）. Univariate analysis revealed that the following factors influenced the 5-year survival rate： patient age, tumor size, depth of invasion, tumor location, operative type, and tumor stage at initial diagnosis. The Cox proportional hazard regression model revealed that tumor size, serosal invasion, and curability were independent, statistically significant, prognostic indicators of lymph node-negative gastric carcinoma. CONCLUSION： Lymph node-negative patients have a favorable outcome attributable to high curability, but the patients with relatively large tumors and serosal invasion have a poor prognosis. Curability is one of the most reliable predictors of long-term survival for lymph nodenegative gastric carcinoma patients.
文摘Purpose: The development of malignancy is a life changing concern for many individuals. The classification of the tumor alone does not adequately take into consideration the patient’s physical condition. Thus, a system to classify both the patient and the tumor has been followed-the ORC system. Method: Additional information regarding the patient and their health has been followed by most physicians but not systematically categorized. By using the individuals health information in addition to the TNM classification one can more adequately advise the patient. Thus O-operability, R-resectability, and C-curability are all considered and more appropriately define the patient and his/her tumor condition. Results: The patient’s physical condition must be acceptable for the treatment-whether surgical or nonsurgical. Pulmonary, cardiac, muscular, renal or other disease entities must not be so severe as to prevent treatment (operability). The lesion should be in a location and of a size to afford possible excision-resectability, and the tumor should be potentially curable in order to justify major intervention. Thus, by combining the patient’s specific health status as well as the tumor characteristics (TNM) a better clarification of the treatment, the options, and the prognosis are delineated. Conclusion: When a patient is seen with a tumor-malignant or benign, therapeutic considerations must include the individual’s health status as well as the tumor prior to determining the treatment. Therefore, a system to consider both the health and the tumor is proposed-the ORC system.
