远端胃切除术后残胃癌随时间变化的临床病理特征
Clinicopathologic features of remnant gastric cancer over time following distal gastrectomy.
作者信息
Zhang De-Wei, Dong Biao, Li Zhen, Dai Dong-Qiu
机构信息
De-Wei Zhang, Biao Dong, Zhen Li, Dong-Qiu Dai, Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China.
出版信息
World J Gastroenterol. 2015 May 21;21(19):5972-8. doi: 10.3748/wjg.v21.i19.5972.
AIM
To investigate remnant gastric cancer (RGC) at various times after gastrectomy, and lay a foundation for the management of RGC.
METHODS
Sixty-five patients with RGC > 2 years and < 10 years after gastrectomy (RGC I) and forty-nine with RGC > 10 years after gastrectomy (RGC II) who underwent curative surgery were enrolled in the study. The clinicopathologic factors, surgical outcomes, and prognosis were compared between RGC I and RGC II.
RESULTS
There was no significant difference in surgical outcomes between RGC I and RGC II. For patients reconstructed with Billroth II, significantly more patients were RGC II compared with RGC (71.9% vs 21.2%, P < 0.001), and more RGC II patients had anastomotic site locations compared to RGC I (31.0% vs 56.3%, P = 0.038). The five-year survival rates for the patients with RGC I and RGC II were 37.6% and 47.9%, respectively, but no significant difference was observed. Borrmann type and tumor stage were confirmed to be independent prognostic factors in both groups.
CONCLUSION
RGC II is located on the anastomotic site in higher frequency and more cases develop after Billroth II reconstruction than RGC I.
目的
研究胃切除术后不同时间发生的残胃癌（RGC），为残胃癌的治疗奠定基础。
方法
本研究纳入了65例胃切除术后2年以上且不足10年发生残胃癌（RGC I）的患者和49例胃切除术后10年以上发生残胃癌（RGC II）且接受了根治性手术的患者。比较RGC I和RGC II之间的临床病理因素、手术结果和预后。
结果
RGC I和RGC II之间的手术结果无显著差异。对于采用毕罗Ⅱ式重建的患者，RGC II患者显著多于RGC患者（71.9%对21.2%，P<0.001），且RGC II患者吻合口部位的比例高于RGC I患者（31.0%对56.3%，P = 0.038）。RGC I和RGC II患者的五年生存率分别为37.6%和47.9%，但未观察到显著差异。Borrmann分型和肿瘤分期被证实为两组的独立预后因素。
结论
RGC II位于吻合口部位的频率更高，与RGC I相比，更多病例在毕罗Ⅱ式重建后发生。
Zotero 插件