Study On The Factors Of Affecting The Prognosis Of Advanced Gastric Cancer With PT_4aN_OM_O Period

Background and Objective Gastric cancer is one of the most popular malignant tumors in the world,the current treatment for the treatment of gastric cancer is mainly based on the comprehensive treatment of surgical treatment.For advanced gastric cancer,people generally agree that D2 radical surgery is the standard treatment,at the same time postoperative pathological staging as an important basis for guiding the treatment of late.In the progression of advanced gastric cancer,advanced gastric cancer without lymph node metastasis had been paid more and more attention because of its particularity.The study of its prognostic factors and recurrence pattern had been continuously updated.In this study,57 cases of postoperative pathological staging prompted p T4 a N0M0 gastric cancer patients with clinical and pathological datas to guide its treatment which had important clinical significance.Methods Collect the clinicopathological data of patients with gastric cancer treated by T4 a N0M0 between January 2009 to January 2011 from the Third Affiliated Hospital of An Hui Medical University(Hefei First People’s Hospital and Hefei Binhu Hospital).The COX regression model was used to analyze the prognosis of the patients.The data were analyzed between sex,age,BMI,tumor location,tumor size,number of negative lymph nodes,postoperative adjuvant chemotherapy and tumor differentiation and five-year survival rate.Significant factors were analyzed bymultivariate analysis,P <0.05 was considered statistically significant.Result The results showed that 57 patients with p T4 a N0M0 pathological stage,42 males,15 females,aged 41-79 years,mean age 65.5 years,most patients,BMI index in the normal range,37 patients with underlying diseases,12 cases had a history of hypertension for many years,13 cases of diabetes,5 cases of hypertension with diabetes,3 cases of preoperative diagnosis of pneumonia,4 cases of previous history of cerebral infarction,postoperative hospital stay of 14-90 days,The number of days was 28.2 days,the longest hospital stay in patients with delayed gastric emptying after 1 week and prolonged hospitalization time.The 5-year survival rate of p T4 a N0M0 gastric cancer was 55.6%.Univariate analysis showed no significant difference in sex,age,BMI,tumor location with p T4 a N0M0 gastric cancer 5-year survival rate(P> 0.05).There was significant difference in tumor size,number of negative lymph nodes,postoperative adjuvant chemotherapy,tumor differentiation(P <0.05).A multivariate analysis was performed to establish a multivariate analysis of COX regression models.The independent risk factors associated with the prognosis of patients with p T4 a N0M0 gastric cancer were obtained.The order of the risk factors with Wald order(P <0.05,Exp(B)= 2.642,1.305,1.613,1.674)is Postoperative adjuvant chemotherapy,tumor size,the number of negative lymph nodes and tumor differentiation.Conclusion Gender,age,BMI,tumor location have no significant correlation with p T4 a N0M0 stage gastric cancer,Meanwhile,Tumor size,the number of negative lymph nodes,postoperative adjuvant chemotherapy,tumor differentiation are associated with p T4 a N0M0 stage gastric cancer,and they are independent riskfactors for prognosis,which postoperative adjuvant chemotherapy is the most important factor.