Konishi Tomoki, Kosuga Toshiyuki, Ichikawa Daisuke, Komatsu Shuhei, Okamoto Kazuma, Konishi Hirotaka, Shiozaki Atsushi, Fujiwara Hitoshi, Arita Tomohiro, Morimura Ryo, Murayama Yasutoshi, Kuriu Yoshiaki, Ikoma Hisashi, Nakanishi Masayoshi, Otsuji Eigo
Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1208-1210.
This study aimed to examine the clinicopathological factors and prognoses of 5 patients with Stage IV gastric cancer(GC) who underwent chemotherapy followed by R0 resection at our institute from 2004 to 2013. Two patients had non-regional lymph node metastases, another 2 patients had peritoneal disseminations, and 1 patient had peritoneal dissemination and non-regional lymph node and left adrenal metastases. All patients underwent R0 resections following 2-6 courses of chemotherapy using multiple anticancer drugs. The disappearance of GC cells in non-regional lymph nodes and peritoneal nodules was confirmed. Clavien-Dindo II or less postoperative complications were found in 3 patients, but no perioperative mortality was observed. The histological response of the primary tumor to preoperative chemotherapy was determined as grade 1b or higher in every case. Although GC recurrence was found in 3 patients, 2 patients are alive without any recurrence. The median survival time of 5 patients was 28(range: 14-61)months. Some patients with Stage IV GC could achieve long-term survival due to chemotherapy followed by R0 resection.
本研究旨在探讨2004年至2013年期间在我院接受化疗后行R0切除的5例IV期胃癌（GC）患者的临床病理因素及预后情况。2例患者有非区域淋巴结转移，另外2例患者有腹膜播散，1例患者有腹膜播散、非区域淋巴结及左肾上腺转移。所有患者在使用多种抗癌药物进行2 - 6个疗程化疗后接受了R0切除。非区域淋巴结和腹膜结节中的GC细胞消失得到证实。3例患者出现Clavien-Dindo II级或以下的术后并发症，但未观察到围手术期死亡。在每例病例中，原发肿瘤对术前化疗的组织学反应均确定为1b级或更高。尽管3例患者出现了GC复发，但2例患者仍存活且无任何复发。5例患者的中位生存时间为28（范围：14 - 61）个月。部分IV期GC患者通过化疗后行R0切除可实现长期生存。
