[胃体癌的合理手术及预后分析]

[The reasonable surgery for gastric body cancer and prognostic analysis].

作者信息

Wang Li, Liang Han, Wang Xiao-na, Ding Xue-wei, Wu Liang-liang, Liu Hong-gen

机构信息

Department of Gastrointestinal Cancer, Key Laboratory of Cancer Prevention and Treatment of Tianjin, Tianjin Cancer Hospital, Tianjin Medical University, Tianjin 300060, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2012 Nov;50(11):966-70.

PMID:23302477

Abstract

OBJECTIVE

To discuss the reasonable surgery for gastric body cancer.

METHODS

From January 2001 to December 2006, the clinicopathological data of 145 patients with a tumor in the middle third of the stomach underwent radical gastric resection were analyzed retrospectively. We conducted comparative analysis for the differences in clinicopathological characteristics and prognosis between total gastrectomy (TG) and subtotal gastrectomy (STG).

RESULTS

The 98 patients underwent TG, 47 received STG. There were significant differences in aspects of tumor size, depth of tumor, nodal status and TNM stage between the 2 groups. Patients with more advanced cancer were more likely to receive TG. The 5-year survival rate for TG was lower (25.5%) than STG (63.8%) (χ(2) = 11.707, P = 0.000). However, if tumor stages were stratified, there was no significant difference in the 5-year survival rate. TNM stage (P = 0.044) and histologic type (HR = 1.834, 95%CI: 1.073 - 3.135, P = 0.027) were independent prognostic factors.

CONCLUSIONS

The overall survival rate of STG for gastric cancer in the middle third of the stomach is better than that of TG. If the radical resection margin can be obtained for gastric body carcinoma, STG is considered instead of TG.

摘要

目的

探讨胃体癌的合理手术方式。

方法

回顾性分析2001年1月至2006年12月145例胃中1/3肿瘤患者行根治性胃切除的临床病理资料。对全胃切除术（TG）和胃次全切除术（STG）的临床病理特征及预后差异进行比较分析。

结果

98例行TG，47例行STG。两组在肿瘤大小、肿瘤深度、淋巴结状态及TNM分期方面存在显著差异。癌症进展程度较高的患者更有可能接受TG。TG的5年生存率（25.5%）低于STG（63.8%）（χ² = 11.707，P = 0.000）。然而，若对肿瘤分期进行分层，5年生存率无显著差异。TNM分期（P = 0.044）和组织学类型（HR = 1.834，95%CI：1.073 - 3.135，P = 0.027）是独立的预后因素。