目的观察早期子宫内膜癌患者的复发和生存状况,探讨其影响因素。方法回顾性分析2007年1月至2010年12月期间我院妇产科收治的78例早期子宫内膜癌患者的临床病理资料和术后生存状况。采用Kaplan-Meier法计算年龄、病理分级、类型等各亚组...目的观察早期子宫内膜癌患者的复发和生存状况,探讨其影响因素。方法回顾性分析2007年1月至2010年12月期间我院妇产科收治的78例早期子宫内膜癌患者的临床病理资料和术后生存状况。采用Kaplan-Meier法计算年龄、病理分级、类型等各亚组3年无病生存率(DFS),并用Log-rank检验进行比较。采用单因素和多因素Cox比例风险回归模型进行预后分析。结果 78例患者术后均获得随访,随访时间为6~79个月,中位随访时间为58个月。全部患者中复发13例(16.7%),中位复发时间为46个月(6~76个月),其中10例在术后5年内复发。全部患者的3年DFS为91.5%。病理分期、分级、类型、肿瘤最大径、术前血清CA125水平是导致直肠癌患者预后不良的独立危险因素,而淋巴结清扫是其保护因素(P<0.05)。结论早期子宫内膜癌的整体预后较好,但对于Ⅱ期、G3级、特殊类型、肿瘤最大径>2 cm、术前血清CA125水平>35 k U/L、未进行淋巴结清扫的患者应在术后5年内密切随访,早期发现复发转移。展开更多
Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrect...Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative treatment.Conclusions: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies.展开更多
文摘目的观察早期子宫内膜癌患者的复发和生存状况,探讨其影响因素。方法回顾性分析2007年1月至2010年12月期间我院妇产科收治的78例早期子宫内膜癌患者的临床病理资料和术后生存状况。采用Kaplan-Meier法计算年龄、病理分级、类型等各亚组3年无病生存率(DFS),并用Log-rank检验进行比较。采用单因素和多因素Cox比例风险回归模型进行预后分析。结果 78例患者术后均获得随访,随访时间为6~79个月,中位随访时间为58个月。全部患者中复发13例(16.7%),中位复发时间为46个月(6~76个月),其中10例在术后5年内复发。全部患者的3年DFS为91.5%。病理分期、分级、类型、肿瘤最大径、术前血清CA125水平是导致直肠癌患者预后不良的独立危险因素,而淋巴结清扫是其保护因素(P<0.05)。结论早期子宫内膜癌的整体预后较好,但对于Ⅱ期、G3级、特殊类型、肿瘤最大径>2 cm、术前血清CA125水平>35 k U/L、未进行淋巴结清扫的患者应在术后5年内密切随访,早期发现复发转移。
基金supported by Scientific and Technological Innovation Joint Capital Projects of Fujian Province, China (No. 2017Y9011)Minimally Invasive Medical Center of Fujian Province (No. [2017]171)+1 种基金Project supported by the Science Foundation of the Fujian Province, China (No. 2018J01307)Joint Funds for the innovation of science and Technology, Fujian province (No. 2018Y9041)。
文摘Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative treatment.Conclusions: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies.
