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胃原发性小细胞癌 20 年诊治经验(1990-2011 年)——中国肿瘤医院病例报道

Primary small cell carcinoma of the stomach: an experience of two decades (1990-2011) in a Chinese cancer institute.

机构信息

Department of Medical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.

出版信息

J Surg Oncol. 2012 Dec;106(8):994-8. doi: 10.1002/jso.23186. Epub 2012 Jun 4.

Abstract

BACKGROUND

Primary gastric small cell carcinoma (GSCC) is a rare and aggressive disease for which the standard treatment has not been established. The objective of this study is to investigate the clinical characteristics and survival.

METHODS

All cases of GSCC treated at our institute from January 1990 to December 2011 were reviewed and analyzed retrospectively. Statistical analyses were performed using Fisher's exact test.

RESULTS

A total of 19 patients from 11,603 cases (0.16%) of all gastric cancers treated during this period were identified. The median age was 61 years and the patients were predominantly men. Using the latest AJCC Staging Criteria, the majority of the patients (68.4%) were Stage III. All patients underwent surgery. The median overall survival time (MST) was 19.5 months (95% CI 17.5-21.6 months). The 1-, 3-, and 5-year overall survival rates were 77.3%, 44.2%, and 22.1%, respectively. The MST of 48.5 months for cases who received postoperative adjuvant chemotherapy was superior to that of 19.0 months for cases who did not (P = 0.026).

CONCLUSIONS

Our data indicate that GSCC patients can be treated effectively with combined modality of treatment, despite the aggressive nature of GSCC. Systemic therapy, based on chemotherapy with surgery, is recommended.

摘要

背景

原发性胃小细胞癌(GSCC)是一种罕见且侵袭性很强的疾病,其标准治疗方法尚未确立。本研究旨在探讨其临床特征和生存情况。

方法

回顾性分析我院 1990 年 1 月至 2011 年 12 月期间收治的所有 GSCC 患者的临床资料。采用 Fisher 确切概率法进行统计学分析。

结果

共纳入 19 例患者,均来自同期收治的 11603 例胃癌患者(0.16%)。患者中位年龄为 61 岁,男性多见。按照最新的 AJCC 分期标准,大多数患者(68.4%)为Ⅲ期。所有患者均接受了手术治疗。中位总生存时间(MST)为 19.5 个月(95%CI 17.5-21.6 个月)。1、3、5 年总生存率分别为 77.3%、44.2%和 22.1%。术后接受辅助化疗患者的 MST 为 48.5 个月,明显长于未接受化疗患者的 19.0 个月(P=0.026)。

结论

尽管 GSCC 侵袭性较强,但采用综合治疗手段可有效治疗 GSCC 患者。推荐以化疗为基础的手术联合全身治疗。

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