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对于患有单一腹膜转移的胃癌患者,谁将从非根治性切除术中获益?

Who will benefit from noncurative resection in patients with gastric cancer with single peritoneal metastasis?

作者信息

Xia Xiang, Li Chen, Yan Min, Liu Bingya, Yao Xuexin, Zhu Zhenggang

机构信息

Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, China.

出版信息

Am Surg. 2014 Feb;80(2):124-30. doi: 10.1177/000313481408000219.

Abstract

The value of noncurative resection for patients with gastric cancer with single peritoneal metastasis is still debatable. This study was undertaken to evaluate the survival benefit of resection in those patients. From 2006 to 2009, 119 patients with gastric cancer with single peritoneal metastasis were identified during surgery. Sixty-three of them had noncurative resection; the remainder had nonresection. Clinicopathological variables and survival were analyzed. Overall survival of patients in the noncurative resection group was longer than that in the nonresection group (14.869 vs 7.780 months). This survival advantage was still significantly better in the P1/P2 patients who underwent noncurative resection (mean survival time 21.164 vs 7.636 months, P = 0.001), but not in the P3 group (P = 0.489). Multivariate analysis indicated that only noncurative resection retained a significant association with better prognosis in P1/P2 patients. The perioperative mortality rate in the resection group was not significantly higher than that of the noncurative group (P = 0.747). Noncurative resection can prolong the survival of patients with gastric cancer with single P1/P2 peritoneal metastasis. This surgical approach should not be taken into account for those patients with P3 gastric cancer.

摘要

对于伴有单一腹膜转移的胃癌患者,非根治性切除术的价值仍存在争议。本研究旨在评估此类患者行切除术的生存获益情况。2006年至2009年期间,手术中确诊119例伴有单一腹膜转移的胃癌患者。其中63例行非根治性切除术,其余患者未行手术。分析临床病理变量及生存情况。非根治性切除组患者的总生存期长于未手术组(14.869个月 vs 7.780个月)。在接受非根治性切除术的P1/P2患者中,这种生存优势仍然显著更好(平均生存时间21.164个月 vs 7.636个月,P = 0.001),但在P3组中则不然(P = 0.489)。多因素分析表明,在P1/P2患者中,只有非根治性切除术与较好的预后仍存在显著关联。切除组的围手术期死亡率并不显著高于非根治性切除组(P = 0.747)。非根治性切除术可延长伴有单一P1/P2腹膜转移的胃癌患者的生存期。对于P3期胃癌患者,不应考虑这种手术方式。

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