Lupaşcu C, Andronic D, Ursulescu C, Vasiluţă C, Raileanu G, Georgescu S t, Niculescu D, Crumpei F, Târcoveanu E
Department of Surgery, University of Medicine and Pharmacy Gr. T. Popa Iaşi, Romania.
Chirurgia (Bucur). 2010 Jul-Aug;105(4):473-6.
Patients with metastatic gastric cancer are usually not good operative candidates. Recent improvements in surgical techniques allowed palliative gastric resection and other surgical procedures.
We have examined the place of palliative gastrectomy and its impact on survival in stage IV gastric cancer patients admitted in 2003-2008 period.
From a total of 295 patients with gastric cancer, we found 140 patients with stage IV disease; 85 of them had no resection (45 received only chemotherapy) and 55 underwent palliative gastric resection with or without postoperative chemotherapy. Mean survival in non-operated patients with chemotherapy alone was 6.4 months, not significantly different to that of the patients with palliative surgery alone (8.9 months). The group with palliative surgery and adjuvant therapy had a significantly better mean survival (17.8 months). Mortality and morbidity rates associated with palliative surgery were 9% and 34.5%, respectively.
These data suggest that palliative surgery associated with adjuvant chemotherapy can improve survival in patients with stage IV gastric cancer.
转移性胃癌患者通常不是手术的合适人选。近年来手术技术的改进使得姑息性胃切除术及其他手术成为可能。
我们研究了2003年至2008年收治的IV期胃癌患者中姑息性胃切除术的地位及其对生存的影响。
在总共295例胃癌患者中，我们发现140例为IV期疾病；其中85例未接受手术（45例仅接受化疗），55例接受了姑息性胃切除术，部分患者术后接受了化疗。单纯化疗的未手术患者的平均生存期为6.4个月，与单纯接受姑息性手术患者的生存期（8.9个月）无显著差异。接受姑息性手术及辅助治疗的患者组平均生存期明显更长（17.8个月）。姑息性手术的死亡率和发病率分别为9%和34.5%。
这些数据表明，姑息性手术联合辅助化疗可提高IV期胃癌患者的生存率。
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