晚期胃癌的姑息性胃切除术

Palliative gastrectomy for advanced gastric cancer.

作者信息

Hanazaki K, Sodeyama H, Mochizuki Y, Igarashi J, Yokoyama S, Sode Y, Wakabayashi M, Kawamura N, Miyazaki T

机构信息

2nd Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

出版信息

Hepatogastroenterology. 2001 Jan-Feb;48(37):285-9.

PMID:11268986

Abstract

BACKGROUND/AIMS: Although palliative gastrectomy for advanced gastric cancer may be favorable in selected patients presenting with bleeding and obstruction, little has been reported about the clinical significance of palliative gastrectomy, including prognosis.

METHODOLOGY

A retrospective comparison between 84 patients with palliative gastrectomy (PG group) and 100 patients with unresectable operation (UO group) for advanced gastric cancer was carried out.

RESULTS

The incidence of serosal invasion, peritoneal dissemination, hepatic and lymph node metastases, and undifferentiated tissue type in the UO group were significantly higher than in the PG group. Median survival after operation in the PG group (20.6 months) was significantly longer than in the UO group (5.7 months). Also, in stage IVb patients, median survival time in the PG group (10.2 months) was significantly longer than in the UO group (5.0 months). However, median survival in the patients with synchronous liver metastasis between PG (8.4 months) and UO (4.6 months) groups was not significantly different. Survival rates after operation of 6 months, 1 year and 2 years in all patients between the palliative gastrectomy group versus UO group were 83.6% versus 38.3% (P < 0.01), 63.0% versus 9.3% (P < 0.01) and 35.2% versus 0% (P < 0.01), respectively.

CONCLUSIONS

Palliative gastrectomy compared to unresectable operation may be effective for improvement of prognosis even if stage IVb patients with peritoneal dissemination and/or distant lymph node metastasis. However, it may be unfavorable on survival of patients with synchronous liver metastasis.

摘要

背景/目的：尽管对于伴有出血和梗阻的晚期胃癌患者，姑息性胃切除术可能有益，但关于姑息性胃切除术的临床意义，包括预后，报道较少。

方法

对84例行姑息性胃切除术的患者（PG组）和100例无法切除手术的晚期胃癌患者（UO组）进行回顾性比较。

结果

UO组的浆膜侵犯、腹膜播散、肝转移和淋巴结转移以及未分化组织类型的发生率显著高于PG组。PG组术后中位生存期（20.6个月）显著长于UO组（5.7个月）。此外，在IVb期患者中，PG组的中位生存时间（10.2个月）显著长于UO组（5.0个月）。然而，PG组和UO组同步肝转移患者的中位生存期无显著差异。姑息性胃切除组与UO组所有患者术后6个月、1年和2年的生存率分别为83.6%对38.3%（P<0.01）、63.0%对9.3%（P<0.01）和35.2%对0%（P<0.01）。