Department of Surgery, Fukuoka City Hospital, 13-1 Yoshizuka-honmachi, Hakata-ku, Fukuoka, 812-0046, Japan.
Surg Today. 2011 Jul;41(7):935-40. doi: 10.1007/s00595-010-4403-0. Epub 2011 Jul 12.
The significance of aggressive chemotherapy for stage IV gastric carcinoma was retrospectively examined.
This study analyzed 94 stage IV gastric cancer patients who underwent surgery with or without subsequent chemotherapeutic treatment. There were 29 potentially curative patients classified as Curability B and 65 noncurative patients classified as Curability C. These patients were divided into three groups chronologically according to the primary type of drugs administered as the 1st (1989-1998), the 2nd (1999-2002), and the 3rd term (2003-2005).
There was no significant difference in the survival time among the three groups (n = 94). The survival time of the patients classified as Curability C (n = 65) in the 3rd-term group (n = 17) was longer than that of the other two groups (P < 0.05). Similarly, the survival time in patients who were given new drugs and regimens (n = 22) was longer than that in those who were not (n = 43) in Curability C (P < 0.05). A multivariate analysis proved that the administrations of new drugs and regimens were independent factors for the prolongation of survival times for patients undergoing noncurative surgery (P < 0.01).
These findings suggested that the administration of new anticancer drugs might bring about a favorable outcome for stage IV gastric cancer patients, especially in those with evidence of a residual tumor.
回顾性研究 IV 期胃癌采用积极化疗的意义。
本研究分析了 94 例行手术治疗并辅以后续化疗的 IV 期胃癌患者。其中 29 例有治愈可能的患者被归类为可治愈性 B 型，65 例无治愈可能的患者被归类为可治愈性 C 型。这些患者根据初始药物的主要类型按时间顺序分为三组：第 1 组（1989-1998 年）、第 2 组（1999-2002 年）和第 3 组（2003-2005 年）。
三组患者（n=94）的生存时间无显著差异。第 3 组（n=17）可治愈性 C 型（n=65）患者的生存时间长于其他两组（P<0.05）。同样，在可治愈性 C 型患者中，接受新药物和方案治疗的患者（n=22）的生存时间长于未接受治疗的患者（n=43）（P<0.05）。多变量分析证实，新药物和方案的使用是接受非治愈性手术患者生存时间延长的独立因素（P<0.01）。
这些发现表明，新抗癌药物的使用可能为 IV 期胃癌患者带来有利的结果，特别是在有肿瘤残留证据的患者中。
