Le Page M, Cauvin J M, Le Dréau G, Nousbaum J B, Enard L, Gourlaouen A, Robaszkiewicz M, Gouérou H
Service d'Hépato-Gastroentérologie, CH de Cornouaille, Quimper.
Gastroenterol Clin Biol. 1995 Oct;19(10):804-10.
The aim of this study was to analyze the evolution of treatment regimens and survival rates of stomach adenocarcinoma recorded in the Finistère cancer registry from 1984 to 1989.
In a population of 838,627 inhabitants, 1,280 patients with a gastric cancer were registered; 1,164 patients (693 males and 471 females) had an adenocarcinoma. Survival rates were estimated by the actuarial method, and compared using the logrank test and the Cox model.
Surgical resection was the main treatment for 661 patients (57%). The frequency of curative resection increased from 25% between 1984 and 1986 to 35% after 1986. Among the other patients, 39 (3%) were treated by chemotherapy and/or radiotherapy, and 53 patients (4%) by endoscopy alone; 253 patients had only symptomatic treatment. The survival rates of all patients were 43% at 1 year and 20% at 5 years. The median survival was 9.2 +/- 0.6 months. In patients with cancer managed surgically, the factors associated with a better prognosis were young age, long duration of symptoms before diagnosis, ulcerated macroscopic aspect, limited tumour extension and curative surgical resection. In other patients, 2 factors were associated a with better prognosis: the absence of metastases and an endoscopic palliative treatment.
Surgical resection is the main treatment of gastric adenocarcinoma. Although the frequency of surgery increased, the prognosis of gastric adenocarcinoma did not improve within this 6-year period.
本研究旨在分析1984年至1989年在菲尼斯泰尔癌症登记处记录的胃腺癌治疗方案的演变和生存率。
在838,627名居民中，登记了1,280例胃癌患者；1,164例患者（693例男性和471例女性）患有腺癌。通过精算方法估计生存率，并使用对数秩检验和Cox模型进行比较。
661例患者（57%）的主要治疗方法是手术切除。根治性切除的频率从1984年至1986年期间的25%增加到1986年后的35%。在其他患者中，39例（3%）接受了化疗和/或放疗，53例患者（4%）仅接受了内镜治疗；253例患者仅接受了对症治疗。所有患者的1年生存率为43%，5年生存率为20%。中位生存期为9.2±0.6个月。在接受手术治疗的癌症患者中，与较好预后相关的因素是年轻、诊断前症状持续时间长、宏观上为溃疡型、肿瘤扩展有限和根治性手术切除。在其他患者中，有两个因素与较好预后相关：无转移和内镜姑息治疗。
手术切除是胃腺癌的主要治疗方法。尽管手术频率增加，但在这6年期间胃腺癌的预后并未改善。
