Cabral Francisco, Ramos Paulo, Monteiro Cecilia, Casaca Rui, Pinto Iola, Abecasis Nuno
Instituto Português Oncologia Lisboa, Lisboa, Portugal.
Instituto Português Oncologia Lisboa, Lisboa, Portugal.
Cir Esp (Engl Ed). 2021 Aug-Sep;99(7):521-526. doi: 10.1016/j.cireng.2021.07.007.
The use of perioperative chemotherapy (CT) in patients with advanced gastric carcinoma increases their overall survival. This therapy may also increase the number of patients with R0 resection. Potential drawbacks of this therapy, besides its toxicity, include increased surgical morbidity.
We retrospectively evaluated the records of patients undergoing gastrectomy with curative intent, for carcinoma, at our institution between January 2009 and August 2018. They were divided into two groups: direct surgery (SURG) and perioperative CT (CHEMO). Patients with other neoadjuvant therapies and cardia Siewert I and II carcinomas were excluded. The primary objective was to evaluate the impact of perioperative CT on surgical morbidity. As secondary objectives, resection radicality and total lymph node count were compared between the two groups.
A total of 307 patients (97 direct surgery and 210 perioperative CT) were evaluated. Median age was 67 years old. The overall major surgical morbidity (Clavien-Dindo 3-5) was 10.6% in the CHEMO group and 12.4 in the SURG group (p=0.643). There was no statistically significant difference between the surgical radicality (R0 98% in the SURG group vs 97.5% CHEMO group (p=0.865). There was an increase in the total number of lymph nodes retrieved in the specimen in the CHEMO group (25 vs 22, p=0.001), a difference that was not maintained in the subgroup analysis as a function of the surgery performed.
Perioperative CT in gastric carcinoma does not increase surgical morbidity, surgical radicality and total lymph node count.
对晚期胃癌患者使用围手术期化疗（CT）可提高其总生存率。这种疗法还可能增加R0切除患者的数量。除了毒性之外，这种疗法的潜在缺点包括手术发病率增加。
我们回顾性评估了2009年1月至2018年8月期间在我院接受根治性胃癌切除术患者的记录。他们被分为两组：直接手术（SURG）和围手术期CT（CHEMO）。排除接受其他新辅助治疗的患者以及贲门Siewert I和II型癌患者。主要目的是评估围手术期CT对手术发病率的影响。作为次要目的，比较两组之间的切除根治性和总淋巴结计数。
共评估了307例患者（97例直接手术和210例围手术期CT）。中位年龄为67岁。CHEMO组的总体主要手术发病率（Clavien-Dindo 3-5级）为10.6%，SURG组为12.4%（p=0.643）。两组之间的手术根治性无统计学显著差异（SURG组R0为98%，CHEMO组为97.5%，p=0.865）。CHEMO组标本中获取的淋巴结总数有所增加（25个对22个，p=0.001），但在根据所进行手术的亚组分析中，这种差异未得到维持。
胃癌围手术期CT不会增加手术发病率、手术根治性和总淋巴结计数。
