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多脏器切除术治疗局部进展期胃癌:一项回顾性研究。

Multivisceral resection for locally advanced gastric cancer: A retrospective study.

机构信息

Department of General Surgery, Peking University First Hospital, Beijing, China.

Department of General Surgery, Peking University First Hospital, Beijing, China.

出版信息

Am J Surg. 2021 May;221(5):1011-1017. doi: 10.1016/j.amjsurg.2020.09.037. Epub 2020 Oct 2.

Abstract

BACKGROUND

Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.

METHODS

We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.

RESULTS

Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.

CONCLUSIONS

cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy.

摘要

背景

多脏器切除术可能是 cT4b 期胃癌患者的唯一根治性手术方法。然而,由于理论上更高的死亡率、发病率和更差的预后,大多数外科医生拒绝选择手术。

方法

我们回顾性分析了 1997 年 1 月 1 日至 2018 年 12 月 31 日接受手术的 cT4b 期胃癌患者。主要终点是总生存。还分析了短期结果和临床病理因素的预后价值。

结果

行多脏器切除术的患者死亡率和发病率可接受。多脏器切除术的 5 年总生存率高于姑息性手术(P<0.05)。多脏器切除术的独立预后因素为 R+切除、广泛淋巴结受累(>15)、血管癌栓和术后化疗。

结论

cT4b 期胃癌患者行多脏器切除术的死亡率和发病率可接受。多脏器切除术的独立预后因素为切除的完整性、广泛的淋巴结受累(>15)、血管癌栓和术后化疗。

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