基于SEER数据库分析老年胃癌患者内镜手术与传统术式的治疗效果及预后*

Analysis of the therapeutic effect and prognosis of endoscopic surgery and traditional surgery in elderly patients with gastric cancer based on SEER database*

摘要:

摘要：目的??基于SEER数据库分析老年胃癌（GC）患者内镜黏膜下剥离术（ESD）与传统术式的治疗效果及预后的影响因素。方法 筛选2014年1月－2014年12月SEER数据库登记的ESD或传统术式治疗的老年T1期原发性GC患者，共865例。分析ESD与传统术式的手术效果，并分析预后的影响因素。结果 865例患者男女比例为1.00∶0.64，29.02%和49.02%的患者合并营养不良（差）与合并慢性疾病，其中接受ESD和传统术式治疗者分别为406和459例，占46.94%和53.06%，5年总生存率为66.36%。ESD和传统术式治疗的老年患者治愈性切除率、完整性切除率和术后复发率比较，差异均无统计学意义（P?>?0.05）；但与传统术式相比，ESD治疗者手术时间和术后住院时间短（P??0.05）；而营养状态、分化程度、淋巴结转移与否、术中是否输血和术后是否复发比较，差异均有统计学意义（P?

Abstract:

Abstract: Objective?To analyze the curative effect of endoscopic submucosal dissection (ESD) and traditional surgery on elderly patients with gastric cancer (GC) and influencing factors of prognosis based on SEER database.?Methods?865 elderly patients with primary GC at stage T1 who underwent ESD or traditional surgery were enrolled in SEER database during the period from January to December of 2014 were screened out. The curative effect of ESD and traditional surgery was analyzed. The influencing factors of prognosis were analyzed.?Results?The ratio of male to female in the 865 patients was 1.00?~?0.64. There were 29.02% and 49.02% of patients with malnutrition (poor) and chronic disease. There were 406 cases and 459 cases underwent ESD and traditional surgery, accounting for 46.94% and 53.06%, respectively. The 5-year overall survival rate was 66.36%. There was no significant difference in healing resection rate, complete resection rate or postoperative recurrence rate between patients underwent ESD and traditional surgery (P?>?0.05). However, compared traditional surgery, operation time and postoperative hospitalization time were shorter in patients underwent ESD, intraoperative blood loss was less, and intraoperative blood transfusion rate was lower (P??0.05), while there differences were statistically significant in nutritional status, differentiation degree, lymph node metastasis, intraoperative blood transfusion and postoperative recurrence (P?