Goto Masakazu, Okitsu Hiroshi, Yuasa Yasuhiro, Kuramoto Shunsuke, Tomibayashi Atsushi, Matsumoto Daisuke, Masuda Yuri, Edagawa Hiroshi, Tani Ryotaro, Mori Osamu, Matsuo Yuta
Department of Gastroenterological Surgery, Tokushima Red Cross Hospital.
J Med Invest. 2016;63(1-2):68-73. doi: 10.2152/jmi.63.68.
The purpose of this study was to investigate the oncologic outcomes of laparoscopic distal gastrectomy (LDG) for advanced gastric cancer (AGC). Between April 2003 and March 2014, LDG was performed for 392 patients, 91 patients (23.2%) had histopathologically diagnosed AGC beyond T2 depth. The clinicopathological features, postoperative outcomes, mortality, morbidity, recurrence rate, and survivals of those patients were reviewed. The TNM stages of the tumor were IB in 26 patients (28.5%), IIA in 20 (21.9%), IIB in 18 (19.7%), IIIA in 13 (14.2%), IIIB in 6 (6.5%), IIIC in 6 (6.5%), and IV in 2 (2.1%). Major morbidity occurred in 14 patients (15.3%), with no postoperative mortality. Median follow-up was 24.5 months; 10 patients developed recurrence during the follow-up period, and 10 patients died, including 6 cancer deaths. The 5-year overall and disease-free survival rates were 76.8% and 72.6%, respectively. By stage, OS/DFS was 92.3%/91.8% in stage IB, 85.4%/85.4% in stage II, and 49.3%/26.9% in stage III. Oncologic outcomes were good in patients with AGC, especially with stage IB-IIB, who underwent LDG. LDG appears to be an effective approach for treating stage IB and II gastric cancer.
本研究旨在探讨腹腔镜远端胃癌切除术(LDG)治疗进展期胃癌(AGC)的肿瘤学结局。2003年4月至2014年3月期间,对392例患者实施了LDG,其中91例(23.2%)经组织病理学诊断为T2深度以上的AGC。回顾了这些患者的临床病理特征、术后结局、死亡率、发病率、复发率和生存率。肿瘤的TNM分期为IB期26例(28.5%)、IIA期20例(21.9%)、IIB期18例(19.7%)、IIIA期13例(14.2%)、IIIB期6例(6.5%)、IIIC期6例(6.5%)、IV期2例(2.1%)。14例患者(15.3%)发生了严重并发症,无术后死亡病例。中位随访时间为24.5个月;10例患者在随访期间出现复发,10例患者死亡,其中6例死于癌症。5年总生存率和无病生存率分别为76.8%和72.6%。按分期计算,IB期的总生存率/无病生存率为92.3%/91.8%,II期为85.4%/85.4%,III期为49.3%/26.9%。接受LDG的AGC患者,尤其是IB-IIB期患者,肿瘤学结局良好。LDG似乎是治疗IB期和II期胃癌的有效方法。