Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, Japan.
Surg Today. 2010;40(2):119-24. doi: 10.1007/s00595-009-4017-6. Epub 2010 Jan 28.
The aim of this study was to clarify the usefulness of staging laparoscopy for planning the treatment strategy in patients with advanced gastric cancer.
This was a retrospective study of patients with gastric cancer who underwent staging laparoscopy. The patients were divided into three groups according to the presence/absence of peritoneal metastasis (P) and positive peritoneal cytology (CY): P negative (0) CY0, P0CY positive (1), and P1CY1. The treatment strategy after staging laparoscopy was as follows: (1) surgery for the P0CY0 group, (2) surgery with neoadjuvant chemotherapy (NAC) for the P0CY1 group, and (3) chemotherapy for the P1CY1 group. Survival was estimated by the Kaplan-Meier method and statistical differences were analyzed by the log-rank test.
Thirty-four patients were included in this study: 11 in the P0CY0 group, 13 in the P0CY1 group, and 10 in the P1CY1 group. A gastrectomy was done in 11, 10, and no patients, respectively. The survival rate of the P0CY0 patients was significantly better than that of the P0CY1 or P1CY1 patients (P = 0.0106 and 0.0031, respectively).
Staging laparoscopy is useful for planning the treatment strategy and estimating the prognosis of patients with advanced gastric cancer.
本研究旨在阐明腹腔镜分期在制定晚期胃癌治疗策略中的作用。
这是一项回顾性研究，纳入了接受腹腔镜分期的胃癌患者。根据腹膜转移（P）和阳性腹膜细胞学（CY）的存在与否，患者分为三组：P 阴性（0）CY0、P0CY 阳性（1）和 P1CY1。腹腔镜分期后的治疗策略如下：（1）P0CY0 组行手术治疗，（2）P0CY1 组行新辅助化疗（NAC）加手术治疗，（3）P1CY1 组行化疗。采用 Kaplan-Meier 法估计生存情况，采用对数秩检验分析统计学差异。
本研究纳入了 34 例患者：P0CY0 组 11 例，P0CY1 组 13 例，P1CY1 组 10 例。分别有 11、10 和无患者行胃切除术。P0CY0 患者的生存率明显优于 P0CY1 或 P1CY1 患者（P=0.0106 和 0.0031）。
腹腔镜分期对制定晚期胃癌治疗策略和评估预后具有重要作用。
