Sun P, Xiang J-B, Chen Z-Y
Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China.
Br J Surg. 2009 Jan;96(1):26-33. doi: 10.1002/bjs.6408.
There is no consensus of opinion about postoperative adjuvant chemotherapy after radical surgery for advanced gastric cancer. This is a meta-analysis of the published results of relevant randomized clinical trials (RCTs).
Electronic databases from January 1998 to December 2007 were searched and 12 RCTs were selected. These included a total of 3809 patients. The hazard ratio (HR) for overall survival was calculated.
The pooled HR for overall survival was 0.78 (95 per cent confidence interval 0.71 to 0.85) in favour of chemotherapy. Subgroup analysis showed that the advantage of chemotherapy was not influenced by depth of tumour infiltration, status of lymph node metastasis, type of lymphadenectomy, geographical distribution of patients or route of drug administration.
Postoperative chemotherapy can improve overall survival after radical surgery for gastric cancer; there is no standardized chemotherapy regimen. Japanese-style D2 radical surgery plus oral 5-fluorouracil appears an effective treatment at present.
对于进展期胃癌根治术后的辅助化疗，目前尚无共识。本文对已发表的相关随机临床试验（RCT）结果进行荟萃分析。
检索1998年1月至2007年12月的电子数据库，选取12项RCT。这些研究共纳入3809例患者。计算总生存的风险比（HR）。
化疗组总生存的合并HR为0.78（95%置信区间0.71至0.85），提示化疗有益。亚组分析显示，化疗的优势不受肿瘤浸润深度、淋巴结转移状态、淋巴结清扫类型、患者地理分布或给药途径的影响。
术后化疗可提高胃癌根治术后的总生存率；目前尚无标准化化疗方案。目前，日式D2根治术加口服5-氟尿嘧啶似乎是一种有效的治疗方法。
