Suzuki Okihide, Fukuchi Minoru, Mochiki Erito, Ishiguro Toru, Sobajima Jun, Onozawa Hisashi, Imaizumi Hideko, Kumagai Youichi, Baba Hiroyuki, Kumamoto Kensuke, Tsuji Yoshitaka, Ishibashi Keiichiro, Ishida Hideyuki
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Int Surg. 2014 Nov-Dec;99(6):830-4. doi: 10.9738/INTSURG-D-14-00119.1.
This retrospective study identified the optimal treatment strategy for patients with gastric cancer with positive peritoneal cytology. We analyzed clinicopathologic and survival data for 54 patients who had undergone gastrectomy and/or chemotherapy for treatment of gastric cancer with positive peritoneal cytology with (n = 40) or without (n = 14) metastatic disease. The median overall survival did not differ significantly between patients with gastric cancer with positive peritoneal cytology with and without metastatic disease (19 versus 13 months, respectively). Among 14 clinicopathologic variables, the lack of gastrectomy was the only significant independent unfavorable factor for survival (odds ratio, 1.64; 95% confidence interval, 1.04-2.57; P = 0.03). The median overall survival significantly differed among patients who had undergone gastrectomy plus chemotherapy, chemotherapy alone, and gastrectomy alone (25, 10, and 17 months, respectively; P < 0.01). Gastrectomy may be optimal for patients with (gastric cancer with positive peritoneal cytology), considering its favorable prognostic effect with respect to perioperative chemotherapy.
这项回顾性研究确定了腹膜细胞学检查呈阳性的胃癌患者的最佳治疗策略。我们分析了54例因腹膜细胞学检查呈阳性的胃癌接受胃切除术和/或化疗的患者的临床病理和生存数据，其中有转移性疾病的患者40例，无转移性疾病的患者14例。腹膜细胞学检查呈阳性且有或无转移性疾病的胃癌患者的中位总生存期无显著差异（分别为19个月和13个月）。在14个临床病理变量中，未进行胃切除术是唯一显著的独立生存不利因素（比值比，1.64；95%置信区间，1.04 - 2.57；P = 0.03）。接受胃切除加化疗、单纯化疗和单纯胃切除术的患者的中位总生存期有显著差异（分别为25个月、10个月和17个月；P < 0.01）。考虑到胃切除术相对于围手术期化疗具有良好的预后效果，对于（腹膜细胞学检查呈阳性的胃癌）患者而言，胃切除术可能是最佳选择。
