Roukos D, Hottenrott C, Lorenz M
Abteilung für Allgemeine und Abdominalchirurgie, Klinikum der J. W. Goethe-Universität, Frankfurt.
Schweiz Med Wochenschr. 1988 May 21;118(20):780-2.
Of 242 gastric cancer patients undergoing surgery in this clinic between 1979 and 1986, 84 (35%) were aged over 70. Staging of patients by the UICC (1978) classification was I: 4.8%, II: 16.7%, III: 18% and IV: 60.5%. Resection rate was 71.4% (60/84) with postoperative hospital mortality of 11.7% (7/60). Mortality in non-resected patients was 25% (6/24). Mortality after total gastrectomy was 11% and after distal resection 5.3%. Actuarial 5-year survival with curative resection was 43.5%, whereas no patient with palliative resection was alive 2 years (range 2-22 months) after surgery (p less than 0.01). These results show that curative resection is the therapy of choice even in elderly patients, due to the low operative risk and excellent survival.
1979年至1986年间,在本诊所接受手术的242例胃癌患者中,84例(35%)年龄超过70岁。根据UICC(1978年)分类法对患者进行分期:I期:4.8%,II期:16.7%,III期:18%,IV期:60.5%。切除率为71.4%(60/84),术后医院死亡率为11.7%(7/60)。未切除患者的死亡率为25%(6/24)。全胃切除术后死亡率为11%,远端切除术后死亡率为5.3%。根治性切除后的精算5年生存率为43.5%,而接受姑息性切除的患者术后无一人存活2年(范围为2至22个月)(p<0.01)。这些结果表明,即使在老年患者中,根治性切除也是首选治疗方法,因为手术风险低且生存率高。