Saito Hiroaki, Yamada Yoshinori, Tsujitani Shunichi, Ikeguchi Masahide
Department of Surgery, Division of Surgical Oncology, Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
Langenbecks Arch Surg. 2009 Jan;394(1):99-103. doi: 10.1007/s00423-008-0398-z. Epub 2008 Aug 2.
To demonstrate clinicopathologic characteristics of gastric cancer patients who underwent noncurative gastrectomy with long-term survival.
We retrospectively reviewed 202 advanced gastric cancer patients who underwent noncurative gastrectomy.
The long-term survivors who survived for more than 3 years comprised four of 65 patients with a residual tumor in the peritoneum, one of 50 patients with a residual tumor from lymph node metastasis, three of 41 patients positive for the resected margin (M-factor) and 17 of 153 patients with free intraperitoneal cancer cells (Cy-factor). Multivariate analysis indicated that independent indicators affecting survival were lymph node metastasis and peritoneal metastasis in patients with the Cy-factor and histology in patients with the M-factor.
Long-term survival can only be expected in patients with the Cy-factor who have neither macroscopic peritoneal metastasis nor lymph node metastasis or in patients with the M-factor who have a well-differentiated tumor.
阐述接受非根治性胃切除术后长期生存的胃癌患者的临床病理特征。
我们回顾性分析了202例行非根治性胃切除术的进展期胃癌患者。
生存超过3年的长期生存者包括65例腹膜残留肿瘤患者中的4例、50例淋巴结转移残留肿瘤患者中的1例、41例切缘阳性(M因素)患者中的3例以及153例腹腔内游离癌细胞(Cy因素)患者中的17例。多因素分析表明,影响生存的独立指标在Cy因素患者中为淋巴结转移和腹膜转移,在M因素患者中为组织学类型。
只有Cy因素患者既无肉眼可见的腹膜转移也无淋巴结转移,或M因素患者肿瘤分化良好时,才有望实现长期生存。