Department of Surgery, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
Gastric Cancer Center, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea.
Medicina (Kaunas). 2021 Feb 26;57(3):198. doi: 10.3390/medicina57030198.
: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. : One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. : Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088-0.324; < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291-0.878; = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296-0.799; = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121-0.895; = 0.030). : PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis.
一项回顾性研究
姑息性原发肿瘤切除术治疗不可切除或转移性胃癌的疗效仍存在争议。本研究旨在评估姑息性胃切除术（PG）对胃癌患者总生存期的影响。
回顾性分析 2011 年 1 月至 2017 年期间接受 PG 或非切除术（NR）治疗的 148 例胃癌患者的临床病理特征，以评估影响预后的因素。
55 例患者因姑息性目的而行原发肿瘤切除术，93 例患者因存在转移性或不可切除性疾病而行 NR 治疗。PG 组患者年龄较小，女性居多。PG 组中，R1 和 R2 切除分别在 2 例（3.6%）和 53 例（96.4%）患者中进行。PG 组的中位总生存期明显长于 NR 组（28.4 与 7.7 个月，<0.001）。多因素分析显示，在 ASA 评分≤1（风险比[HR]，0.169；95%置信区间[CI]，0.088-0.324；<0.001）和接受术后化疗（HR，0.487；95%CI，0.296-0.799；=0.004）的患者中，姑息性切除后的总生存期明显更好。在接受姑息性切除的患者中，<15 个阳性淋巴结是总生存期更好的唯一显著预测因素（HR，0.329；95%CI，0.121-0.895；=0.030）。
PG 可能使某些不可治愈的胃癌患者，特别是淋巴结转移范围较小的患者的生存时间延长。
