Unit of Surgical Oncology, Department of Human Pathology and Oncology, Istituto Toscano Tumouri, University of Siena and ITT, Siena, Italy.
Gastric Cancer. 2012 Jan;15(1):56-60. doi: 10.1007/s10120-011-0063-z. Epub 2011 Jun 30.
The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence.
Results of surgery were analyzed in 102 patients with GLP.
Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases. R2 resection was carried out in 20 patients and R1 in 12 patients, while the resection was considered potentially curative (R0) in 28 (27.5%). Overall, the median (95% confidence interval [CI]) survival time was 5.7 (3.7-7.5) months, with none of the patients alive at the end date of the study. For R0 patients the median (95% CI) survival time was 15.8 (11-20.7) months. The great majority of recurrences were intra-abdominal (peritoneal and/or locoregional), with a systemic component of the relapse that was rarely observed (5 cases).
After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease. Specifically designed multimodality treatment protocols should be tested in this setting.
手术在胃弥漫型大 B 细胞淋巴瘤（GLP）中的作用受到质疑。本研究旨在分析我们在 GLP 手术治疗方面的经验，特别参考可切除性、预后和复发模式。
分析了 102 例 GLP 患者的手术结果。
在 102 例患者中，92 例行手术探查，其中 60 例行切除术。20 例患者行 R2 切除术，12 例患者行 R1 切除术，28 例（27.5%）被认为是潜在可治愈的（R0）。总体而言，中位（95%置信区间[CI]）生存时间为 5.7（3.7-7.5）个月，研究结束时无患者存活。对于 R0 患者，中位（95%CI）生存时间为 15.8（11-20.7）个月。绝大多数复发发生在腹腔内（腹膜和/或局部区域），很少观察到系统性复发（5 例）。
无论切除范围或类型如何，原发性手术后 GLP 的预后均较差。手术治疗失败主要与疾病的腹膜播散有关。应在这一领域中测试专门设计的多模式治疗方案。
