Yabusaki Hiroshi, Nashimoto Atsushi, Matsuki Atsushi, Aizawa Masaki
Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Hepatogastroenterology. 2013 Mar-Apr;60(122):377-81. doi: 10.5754/hge12653.
BACKGROUND/AIMS: The purpose of this study was to evaluate the efficacy of surgical treatment following a response to chemotherapy to improve stage IV gastric cancer and to identify the factors contributing to survival benefit.
In total, 148 patients with cStage IV gastric cancer were treated with S-1 and CDDP. We retrospectively evaluated the factors contributing to a survival benefit and the significance of surgical treatment.
The 148 cStage IV patients included 107 males with a median age of 61 years. The overall response rate was 54.7%. After chemotherapy, 97 patients underwent surgery. R0 resection was successfully performed in 51 (52.6%) patients. The overall median survival time (MST) of the patients was 16.8 months, with a 5YSR of 16.4%. The MST of patients who went on to receive surgery was 22.5 months, and the 5YSR was 19.6%. In the multivariate analysis of 97 patients who underwent surgery, R0 resection, lymph node dissection of D2/D3 and obtaining a CR/PR from chemotherapy were the only independently prognostic factors.
The use of multi-modal treatment, including surgical treatment, at an appropriate time was well tolerated and effective for patients with stage IV gastric cancer.
背景/目的：本研究旨在评估化疗有效后进行手术治疗对改善IV期胃癌的疗效，并确定有助于生存获益的因素。
总共148例cIV期胃癌患者接受了S-1和顺铂治疗。我们回顾性评估了有助于生存获益的因素以及手术治疗的意义。
148例cIV期患者中包括107例男性，中位年龄为61岁。总体缓解率为54.7%。化疗后，97例患者接受了手术。51例（52.6%）患者成功进行了R0切除。患者的总体中位生存时间（MST）为16.8个月，5年生存率（5YSR）为16.4%。接受手术的患者的MST为22.5个月，5YSR为19.6%。在对97例接受手术的患者进行的多因素分析中，R0切除、D2/D3淋巴结清扫以及化疗后获得完全缓解（CR）/部分缓解（PR）是仅有的独立预后因素。
对IV期胃癌患者适时采用包括手术治疗在内的多模式治疗耐受性良好且有效。
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