| Objective: To estimate the effectiveness of adjuvant chemotherapy in patientswith postoperative gastric carcinoma and screen clinicopathological factors in relationto the prognosis of gastric carcinoma, in order to guide clinical treatment and increasethe survival rate.Methods: This is a retrospective analysis.145patients were enrolled in thisstudy，who were performed radical gastrectomy (D2gastrectomy) in the First AffiliatedHospital of Dalian Medical University from August2002to December2006，and forpatients follow-up.145cases were divided into two groups, including patients receivedadjuvant chemotherapy as chemotherapy group,72patients, radical surgery alone as thecontrol group, a total of73patients. Direct method to calculate two sets of3-year and5-year survival rate, and chi-square compared between the two groups of statisticaldifferences of3-and5-year survival rate and3-year disease-free survival (DFS), usingKaplan-Meier method for survival analysis, Log-rank test univariate analysis, to make aclear significant differences in the level of survival rates between the various factors andput the significant difference into the Cox regression model, multivariate analysis wasperformed to determine the independent prognostic factors for patients after radicalgastrectomy.Results:3-year and5-year survival rate in chemotherapy group and control group,comparison:73.6%vs53.4%(P=0.012),59.7%vs47.9%(P=0.014), P <0.05,3-yearDFS: chemotherapy and control groups were63.9%,49.3%(P>0.05), further stratifiedby comparison, two groups of lymph node-positive patients,3-year DFS contrast:54.7%vs32.6%(P=0.027), the results suggest that adjuvant chemotherapy for gastriccarcinoma following radical resection can improve3-year and5-year survival rate and3-year DFS of lymph node-positive patients, the difference has statistical significance.The results of univariate analysis: gender, age, family history, gross type, vascular invasion, had no significant effect on the prognosis of gastric cancer (P>0.05), tumorsite, infiltrative depth, number of lymph node metastasis, clinical stage, histologicaltype, preoperative anemia, tumor markers before surgery, adjuvant chemotherapy werefound to be significantly related to the prognosis in patients with gastric carcinoma (P<0.05). COX regression model for multivariate analysis:clinical stage, adjuvantchemotherapy were independent prognostic factors in patients with gastric carcinoma (P<0.01).Conclusion：Adjuvant chemotherapy after gastrectomy can improve long-termsurvival rate (3-and5-year survival rates were increased by20.2%and11.8%, P <0.05),improve3-year DFS in node-positive patients; adjuvant chemotherapy, clinical stagesand histological type were independent prognostic factors of gastric cancer patients (Pvalues less than0.01)．... |
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