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大体外观和可治愈性是胃癌患者胃周腹膜转移行胃切除术后预后较好的预测因素。

Gross Appearance and Curability Are Predictive Factors of a Better Prognosis After Gastrectomy in Gastric Cancer Patients with Metastasis to the Adjacent Peritoneum of the Stomach.

作者信息

Saito Hiroaki, Kono Yusuke, Murakami Yuki, Kuroda Hirohiko, Matsunaga Tomoyuki, Fukumoto Yoji, Tomohiro Osaki, Fujiwara Yoshiyuki

机构信息

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.

出版信息

Yonago Acta Med. 2017 Sep 15;60(3):174-178. eCollection 2017 Sep.

Abstract

BACKGROUND

Gastric cancer patients with peritoneal metastasis have an extremely poor prognosis. The aim of the current study was to clarify the predictive factors of a better outcome in gastric cancer patients with peritoneal metastasis.

METHODS

We analyzed the records of 2262 gastric adenocarcinoma patients who underwent gastrectomies at our institution between January 1980 and December 2010.

RESULTS

The 5-year survival rates for advanced gastric cancer patients with P1 ( = 43), P2 ( = 56), and P3 ( = 36) metastasis were 16.3%, 0%, and 0%, respectively. The prognosis of P1 gastric cancer patients was significantly better than that of either P2 ( = 0.0003) or P3 patients ( < 0.0001). A multivariate analysis identified gross appearance and curability as independent prognostic indicators in P1 gastric cancer patients. In fact, the prognosis was good for patients in whom an R0/1 resection had been performed and with tumors having a gross appearance of other than type 4, with a 40% 5-year survival rate and a 29-month median survival time.

CONCLUSION

Our data indicated a good prognosis for P1 patients in whom an R0/1 resection could be performed and with tumors having a gross appearance of other than type 4. Therefore, radical surgery and adequate adjuvant chemotherapy should be performed in these patients.

摘要

背景

伴有腹膜转移的胃癌患者预后极差。本研究的目的是阐明伴有腹膜转移的胃癌患者预后较好的预测因素。

方法

我们分析了1980年1月至2010年12月在我院接受胃切除术的2262例胃腺癌患者的记录。

结果

伴有P1(=43)、P2(=56)和P3(=36)转移的进展期胃癌患者的5年生存率分别为16.3%、0%和0%。P1期胃癌患者的预后明显优于P2期(=0.0003)或P3期患者(<0.0001)。多因素分析确定大体形态和可切除性为P1期胃癌患者的独立预后指标。事实上,行R0/1切除且肿瘤大体形态非4型的患者预后良好,5年生存率为40%,中位生存时间为29个月。

结论

我们的数据表明,对于可行R0/1切除且肿瘤大体形态非4型的P1期患者,预后良好。因此,应对这些患者进行根治性手术和适当的辅助化疗。

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