Huguier M, Houry S, Lacaine F
Department of Surgery, Hôpital Tenon, Université Paris, France.
Hepatogastroenterology. 1992 Feb;39(1):14-6.
In patients operated on for gastric carcinoma, the main purpose of a follow-up program is to diagnose recurrent disease and initiate treatment at an early stage. One hundred and ninety-seven consecutive patients were studied, 43 of whom had not received a resection (27%). Resections were carried out in 144 patients, in either palliative (N = 20), or curative (N = 122) intent. The follow-up program included visits to the outpatient clinic at one month, six months, one year, and every year during the five post-operative years. Shorter intervals were employed as indicated by the functional or general status of the patients. One patient has been lost to follow-up. In palliative surgery, median survival was 3 months in patients undergoing laparotomy, 6 months following palliative surgery without resection, and 8 months following palliative resection. In patients who underwent curative resection, 65 are still alive without recurrent disease (57%). Thirty-six of them have been followed-up for more than 5 years. Seven patients died without recurrence. Of 42 patients with recurrence, 10 underwent a reoperation. The only resection was performed for liver metastasis. This patient died 14 months later. Survival in the 9 other patients did not exceed 6 months. This experience suggests that a follow-up program of patients operated on for gastric carcinoma is disappointing.
在接受胃癌手术的患者中，随访计划的主要目的是诊断复发性疾病并在早期启动治疗。对197例连续患者进行了研究，其中43例未接受切除术（27%）。144例患者进行了切除术，其中姑息性切除20例，根治性切除122例。随访计划包括在术后五年内，于术后1个月、6个月、1年以及每年进行门诊复诊。根据患者的功能或一般状况，必要时采用更短的随访间隔。有1例患者失访。在姑息性手术中，接受剖腹手术的患者中位生存期为3个月，未切除的姑息性手术后为6个月，姑息性切除后为8个月。在接受根治性切除的患者中，65例仍存活且无疾病复发（57%）。其中36例已随访超过5年。7例患者无复发死亡。在42例复发患者中，10例接受了再次手术。仅1例因肝转移进行了切除术。该患者14个月后死亡。其他9例患者的生存期不超过6个月。这一经验表明，胃癌手术患者的随访计划令人失望。
