可切除胃癌患者生存时间的改善：日式胃切除术联合D2淋巴结清扫及辅助化疗的作用

Time-related improvement of survival in resectable gastric cancer: the role of Japanese-style gastrectomy with D2 lymphadenectomy and adjuvant chemotherapy.

作者信息

Grau Juan J, Palmero Ramon, Marmol Maribel, Domingo-Domenech Jose, Monzo Mariano, Fuster Jose, Vidal Oscar, Fondevila Constantino, Garcia-Valdecasas Juan C

机构信息

Oncology Department, Institut Clinic de Malalties Hemato-Oncologiques, University of Barcelona, Hospital Clinic, Barcelona, Spain.

出版信息

World J Surg Oncol. 2006 Aug 11;4:53. doi: 10.1186/1477-7819-4-53.

DOI:10.1186/1477-7819-4-53

PMID:16904003

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1564020/

Abstract

BACKGROUND

We investigated the change of prognosis in resected gastric cancer (RGC) patients and the role of radical surgery and adjuvant chemotherapy.

METHODS

We retrospectively analyze the outcome of 426 consecutive patients from 1975 to 2002, divided into 2 time-periods (TP) cohort: Before 1990 (TP1, n = 207) and 1990 or after (TP2; n= 219). Partial gastrectomy and D1-lymphadenectomy was predominant in TP1 and total gastrectomy with D2-lymphadenectomy it was in TP2. Adjuvant chemotherapy consisted of mitomycin C (MMC), 10-20 mg/m2 i.v. 4 courses or MMC plus Tegafur 500 mg/m2 for 6 months.

RESULTS

Positive nodes were similar in TP2/TP1 patients with 56%/59% respectively. Total gastrectomy was done in 56%/45% of TP2/TP1 respectively. Two-drug adjuvant chemotherapy was administered in 65%/18% of TP2/TP1 respectively. Survival at 5 years was 66% for TP2 versus 42% for TP1 patients (p < 0.0001). Survival by stages II, IIIA and IIIB for TP2 versus TP1 patients was 70 vs. 51% (p = 0.0132); 57 vs. 22% (p = 0.0008) and 30 vs. 15% (p = 0.2315) respectively. Multivariate analysis showed that age, stage of disease and period of treatment were independent variables.

CONCLUSION

The global prognosis and that of some stages have improved in recent years with case RGC patients treated with surgery and adjuvant chemotherapy.

摘要

背景

我们研究了接受手术切除的胃癌（RGC）患者的预后变化以及根治性手术和辅助化疗的作用。

方法

我们回顾性分析了1975年至2002年间426例连续患者的结局，将其分为两个时间段（TP）队列：1990年之前（TP1，n = 207）和1990年及之后（TP2；n = 219）。TP1中以部分胃切除术和D1淋巴结清扫术为主，TP2中则以全胃切除术和D2淋巴结清扫术为主。辅助化疗包括丝裂霉素C（MMC），静脉注射10 - 20 mg/m²，共4个疗程，或MMC加替加氟500 mg/m²，持续6个月。

结果

TP2/TP1患者的阳性淋巴结比例分别为56%/59%，较为相似。TP2/TP1患者分别有56%/45%接受了全胃切除术。TP2/TP1患者分别有65%/18%接受了两药辅助化疗。TP2患者的5年生存率为66%，而TP1患者为42%（p < 0.0001）。TP2与TP1患者II期、IIIA期和IIIB期的生存率分别为70%对vs 51%（p = 0.0132）；57%对vs 22%（p = 0.0008）和30%对vs 15%（p = 0.2315）。多因素分析表明，年龄、疾病分期和治疗时期是独立变量。