胃癌骨转移患者临床病理特征及预后影响因素分析

Clinical features and prognosis of gastric cancer with bone metastasis

摘要:

目的 对胃癌骨转移患者临床病理特征及预后进行回顾性分析。方法 收集2005 ～ 2015 年收 治的胃癌骨转移患者139 例，分析患者临床病理特征和治疗对患者生存时间的影响。结果 胃癌患者常见的 骨转移部位依次为脊柱、骨盆及肋骨。胃癌骨转移患者中位生存时间15.1 个月，确诊骨转移后患者中位生存 时间为5.7 个月。TNM 分期、同时或异时性骨转移、是否化疗及是否双膦酸盐治疗是影响胃癌骨转移患者 总生存期的独立预后因素（P <0.05）。而骨转移后是否接受化疗是影响患者骨转移后生存期的独立预后因素 （P <0.05）。结论 骨转移多发生于胃癌病程晚期，患者一旦发生骨转移则提示预后差，化疗可延长患者骨转 移后的生存时间。临床医生应注意筛查并采取积极的治疗措施延长患者生存期。

Abstract:

Objective To evaluate the clinicopathological characteristics and outcomes of gastric cancer patients with bone metastasis. Methods The subjects were 139 gastric cancer patients who were diagnosed with bone metastasis between 2005 and 2015. The influences of pathological characteristics and clinical treatment on the survival time of the patients were analyzed. Results The common sites of bone metastasis were spine, pelvis and ribs. The median survival time of the gastric cancer patients with bone metastasis was 15.1 months, but the median survival time after diagnosis of bone metastasis was only 5.7 months. Tumor stage, simultaneous bone metastasis or not, chemotherapy and bisphosphonate therapy were the independent prognostic factors for overall survival in the gastric patients with bone metastasis (P < 0.05). Whether received chemotherapy or not after bone metastasis was an independent prognostic factor for patients’ survival (P < 0.05). Conclusions Bone metastasis usually occurs in advanced stage of gastric cancer, and indicates poor prognosis. After bone metastasis, accepting chemotherapy can prolong the survival time of the patients. Clinicians should pay more attention and provide active therapy to the gastric cancer patients with bone metastasis.