The Risk Factors Related To Prognosis And Recurrence After Curative Surgery Of 539 Early Gastric Cancer

Objective To analysis the pathoclinical characteristics and to investigate the risk factors related to prognosis and recurrence in 539 early gastric cancer(EGC)patients after radical gastrectomy Methods The clinical data of 539 EGC patients underwent radical surgery from July 2007 to July 2012 were analysed and patients were followed up.Univariate and multivariate analyses were performed by Chi-square test or fisher’s exact test and logistic regression respectively.5-year survival rate was calculated by life-table method.Log-rank test and Cox regression were used for univariate and multivariate analysis to determine the independent factors related to the prognosis of early gastric cancer after surgery.Results The five-year survival rate of EGC was 91.7%.1,3,5 year survival rates were 98.1%,93.6%,89.2%.The recurrence rate of EGC was 5.9%,The liver was the most common site of recurrence.Univariate analysis showed that age,degree of differentiation,depth of invasion,tumor size,neural invasion,vascular invasion and N staging were the risk factors of recurrence of early gastric cancer.Multivariate analysis revealed that N stage,depth of invasion and vascular invasion were the independent risk factors for postoperative relapse of the disease(OR=12.144,11.753,3.142,P<0.05).Univariate analysis indicated that age,depth of invasion,N stage and tumor size,level of CEA,neural invasion,vascular invasion,metastatic lymph nodes ratio were related to patient’s prognosis(P<0.05),multivariate analysis revealed that the level of CEA,metastatic lymph nodes ratio N stage,tumor diameter were the independent prognostic factor(OR=8.275,1.359,P<0.05),Univariate analysis illuminate that age,vascular invasion,tumor size,depth of invasion,degree of differentiation,histological type affect the lymph node metastasis,while logistic analysis found that tumor size,depth of invasion,degree of differentiation were the independent risk factors(OR=5.234,7.382,3.662,P<0.05)Conclusion The prognosis of early gastric cancer are excellent after radical surgery,but there are still certain proportion of local recurrence and distant metastasis.N stage,vascular invasion and depth of invasion are associated with cancer recurrence.tumor size,depth of invasion,degree of differentiation were associate with lymph node metastasis,while the level of CEA,metastatic lymph nodes ratio,N stage and tumor size are related to prognosis of EGC.Follow-up is still necessary,especially for those who occupy the high risk factors of recurrence and metastasis.