Relevant factors analysis on the survival of gastric cancer patients with lung metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the factors affecting survival rate in gastric cancer patients with lung metastasis.</p><p><b>METHODS</b>Clinicopathological and follow-up data of 64 gastric cancer patients with lung metastasis treated at the Cancer Hospital of Tianjin Medical University from January 1995 to December 2011, were retrospectively analyzed. The survival rate was calculated. Univariate and multivariate analysis were performed to find the factors affecting survival rate using Log-rank test and Cox proportional hazards model, respectively.</p><p><b>RESULTS</b>The median survival time was 7 months. The 1-, 2- and 3-year survival rates were 32.8%, 18.8% and 7.8% respectively. Univariate analysis showed that primary tumor location, type of lung metastasis, lung metastasis combined with other distant metastasis and chemotherapy were significant factors for prognosis (P<0.05). Multivariate analysis revealed that bilateral lung metastasis(HR=2.093, 95% CI: 1.092-4.014, P=0.026) and lung metastasis combined with other distant metastasis (HR=2.433, 95% CI: 1.359-4.358, P=0.003) were independent risk prognostic factors, while chemotherapy was independent protective factor(HR=0.387, 95% CI: 0.211-0.710, P=0.002).</p><p><b>CONCLUSIONS</b>Prognosis of gastric cancer patients with lung metastasis is quite poor, especially those with bilateral lung involvement and extra-pulmonary metastasis. Systemic chemotherapy may improve the prognosis of these patients.</p>

Analysis of prognostic factors of 110 patients with metastatic ovarian tumors from gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinicopathalogical features, treatment methods and prognostic factors of metastatic ovarian tumors from gastric cancer.</p><p><b>METHOD</b>Clinical data of 110 gastric cancer patients with metastatic ovarian tumor between January 2001 and August 2015 of Tianjin Medical University Cancer Institute and Hospital were reviewed retrospectively. Univariate and Cox regression model multivariate analyses were performed to investigate the risk factors of metastatic ovarian tumor from gastric cancer.</p><p><b>RESULT</b>The follow-up duration ranged from 3 to 60 months (mean 12 months). The follow-up rate was 94.5%(104/110). 104 cases underwent surgical treatment, including satisfactory cytoreductive surgery (57 cases) and unsatisfactory cytoreductive surgery (47 cases). The median overall survival was 12 months and median progression-free survival was 8 months. The survival rates of 1-, 3- and 5-year were 48.1%, 7.7% and 0, respectively. Univariate analysis revealed that pattern of metastasectomy, number of metastatic lymph node, cytoreductive surgery level, presence of peritoneal metastasis or not when ovarian metastasis was diagnosed, ovariectomy prior to primary gastric cancer and extent of ovarian metastatic lesion were associated with prognosis(P<0.05). Multivariate analysis revealed that extent of ovarian metastatic lesion(RR=2.76, 95% CI: 1.68 to 4.54, P=0.005), presence of peritoneal metastasis when ovarian metastasis was diagnosed (RR=0.21, 95% CI: 0.11 to 0.41, P=0.003) and cytoreductive surgery level(RR=3.67, 95% CI: 2.13 to 6.33, P=0.011) were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Prognosis of patients with metastatic ovarian carcinoma from gastric cancer is quite poor. Extent of ovarian metastatic lesion and peritoneal metastasis were independent prognostic factors. Optimal cytoreduction is associated with better survival.</p>

Risk factors of reoperation for remnant stomach cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the risk factors influencing patients with recurrent remnant stomach cancer to receive radical re-resection.</p><p><b>METHODS</b>Clinicopathological data of 93 patients undergoing reoperation because of postoperative local recurrence of gastric carcinoma in Tianjin Medical University Cancer Institute and Hospital from January 2003 to May 2014 were analyzed retrospectively. Patients were divided into radical re-resection group and non-radical re-operation group. The characteristics of two groups were compared and evaluated by univariate and multivariate analysis.</p><p><b>RESULTS</b>Among 93 patients, 41 were treated by radical re-resection and 52 by non-radical re-operation. Univariate analysis showed that reconstruction, lymph nodes dissection extent, N stage, TNM stages of the initial operation, interval between initial operation and recurrence, presenting symptoms, the interval between clinical symptom appearance or definite diagnosis and re-resection, tumor markers increasing before re-operation were significant factors associated with the chance to receive radical reoperation(P<0.05). Multivariate Logistic regression analysis revealed presenting symptoms(RR=3.684, 95% CI:1.233-11.009, P=0.020) and TNM stages of initial operation(RR=0.266, 95% CI:0083-0.853, P=0.026) were independent factors associated with the chance to radical reoperation(P<0.05).</p><p><b>CONCLUSIONS</b>Symptomatic recurrence and advanced TNM stages of initial operation are independent risk factors associated with patients who develope local recurrence of remnant stomach cancer to receive radical reoperation.</p>