Maehara Y, Tomisaki S, Emi Y, Sakaguchi Y, Kusumoto T, Ichiyoshi Y, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Anticancer Res. 1995 May-Jun;15(3):1049-53.
The appearance of a second cancer in patients who had undergone curative operation for the first gastric cancer is one of the crucial problems for the clinician. We analysed data on 910 patients with gastric cancer treated with curative resection, with respect to the risk factors for second primary cancer and the prognosis. Of 910 patients, 69 (7.6%) died with a second primary cancer. In patients with a second primary cancer, there were more men and age was more advanced, compared to the survivors. The gastric tumor was larger, the serosal invasion was more prominent and lymphatic involvement was more frequent. The postoperative 5-year survival for patients with a second primary cancer was 60.9%, the 10-year rate was 31.9% and the 15-year was 19.6%. Multivariate analysis revealed that risk factors for a second primary cancer was advanced age, male sex and a larger tumor. Our findings suggest that during the follow-up of patients with gastric cancer treated by curative resection and risk factors, a second primary cancer may occur in other organs, in addition to a recurrence of the first cancer.
对于接受过首次胃癌根治性手术的患者而言,出现第二原发癌是临床医生面临的关键问题之一。我们分析了910例行胃癌根治性切除术患者的数据,内容涉及第二原发癌的危险因素及预后情况。在910例患者中,69例(7.6%)死于第二原发癌。与存活患者相比,患第二原发癌的患者中男性更多,年龄更大。胃肿瘤更大,浆膜侵犯更显著,且淋巴结受累更频繁。患第二原发癌患者的术后5年生存率为60.9%,10年生存率为31.9%,15年生存率为19.6%。多因素分析显示,第二原发癌的危险因素为高龄、男性以及肿瘤更大。我们的研究结果表明,在对接受根治性切除术且存在危险因素的胃癌患者进行随访期间,除了第一癌症复发外,其他器官可能会发生第二原发癌。