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在一项病例对照研究中,胃残端癌患者手术后的预后比胃上部三分之一癌症患者更好。

Gastric remnant cancer patients had a better prognosis than upper-third gastric cancer patients in a case-control study after surgical treatment.

作者信息

Li Fangxuan, Zhang Rupeng, Liang Han, Quan Jichuan, Liu Hui, Zhang Hui

出版信息

Tumori. 2013 Jul-Aug;99(4):510-5. doi: 10.1177/030089161309900412.

Abstract

BACKGROUND

The aim was to compare the clinicopathological features and prognostic outcomes of gastric remnant carcinoma patients with those of patients with upper-third gastric cancer.

METHODS

Clinical data extracted from 112 gastric remnant carcinomas and 367 upper-third gastric cancer patients were analyzed to explore the clinicopathologic differences between two groups. After radical resection, prognostic difference between them was evaluated through a 1:2 matched case-control study.

RESULTS

The pattern of gastric remnant carcinomas showed a male predominance. Undifferentiated type histology, depth at T4 stage and distant metastases were more frequent in gastric remnant carcinomas than in upper-third gastric cancers (P <0.05). The radical resectability of gastric remnant carcinomas was lower and the multi-visceral resectabilitiy was relatively higher than the other group (P = 0.00). Gastric remnant carcinomas trended to have a higher incidence of metastases to either mesojejunum or lower mediastinal lymph nodes than upper-third gastric cancers, but patient survival was not significantly different. In the case-control study, gastric remnant carcinomas had a better prognosis than upper-third gastric cancers after radical resection when the clinicopathologic features and surgical treatment were matched.

CONCLUSIONS

Although there was no significant prognostic distinction between gastric remnant carcinomas and upper-third gastric cancer, after radical surgical treatment, patients with the former had an even better prognosis.

摘要

背景

目的是比较残胃癌患者与胃上部癌患者的临床病理特征及预后结果。

方法

分析从112例残胃癌患者和367例胃上部癌患者中提取的临床数据,以探讨两组之间的临床病理差异。根治性切除术后,通过1:2匹配病例对照研究评估两者之间的预后差异。

结果

残胃癌患者以男性为主。与胃上部癌相比,残胃癌的未分化型组织学、T4期深度及远处转移更为常见(P<0.05)。残胃癌的根治性切除率较低,多脏器切除率相对高于另一组(P = 0.00)。与胃上部癌相比,残胃癌转移至空肠系膜或下纵隔淋巴结的发生率有升高趋势,但患者生存率无显著差异。在病例对照研究中,当临床病理特征和手术治疗相匹配时,根治性切除术后残胃癌患者的预后优于胃上部癌患者。

结论

虽然残胃癌与胃上部癌之间无显著的预后差异,但根治性手术治疗后,前者患者的预后甚至更好。

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