Tao Ke-long, Huang Chang-ming, Lin Jian-xian, Zheng Chao-hui, Li Ping, Xie Jian-wei, Wang Jia-bin
Department of Gastric Surgery, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Feb;16(2):155-9.
To investigate the impact of the extent of gastric resection on the prognosis of patients with middle one-third gastric cancer.
From January 1998 to December 2005, 222 patients with middle one-third gastric cancer underwent D2 radical resection in the Affiliated Union Hospital, Fujian Medical University. Among them, 66 underwent distal gastrectomy (DG group), while 156 underwent total gastrectomy (TG group). The 5-year survival rates were compared between two groups. The prognostic factors were evaluated by univariate and multivariate analyses.
The 5-year survival rates of DG group and TG group were 63.9% and 49.8% respectively, with significant difference (P<0.05). Nevertheless, compared to DG group, the tumors in TG group had bigger size, later TNM stage, and higher proportion of locating lesser curvature of stomach (all P<0.01). Multivariate analysis revealed that invasion depth, lymph node metastasis and TNM classification were independent prognostic factors (all P<0.05), but the extent of gastric resection was not (P>0.05).
If curative resection can be performed, the long-term prognosis of patients with middle one-third gastric cancer is not affected by the extent of gastric resection, and distal gastrectomy is feasible.
探讨胃切除范围对胃中上部癌患者预后的影响。
1998年1月至2005年12月,福建医科大学附属协和医院222例胃中上部癌患者接受了D2根治性切除术。其中,66例行远端胃切除术(DG组),156例行全胃切除术(TG组)。比较两组的5年生存率。通过单因素和多因素分析评估预后因素。
DG组和TG组的5年生存率分别为63.9%和49.8%,差异有统计学意义(P<0.05)。然而,与DG组相比,TG组肿瘤体积更大,TNM分期更晚,位于胃小弯侧的比例更高(均P<0.01)。多因素分析显示,浸润深度、淋巴结转移和TNM分类是独立的预后因素(均P<0.05),但胃切除范围不是(P>0.05)。
如果能进行根治性切除,胃中上部癌患者的长期预后不受胃切除范围的影响,远端胃切除术是可行的。