高龄胃癌患者外科个体化治疗65例

Individualized surgical treatment of elderly patients with gastric carcinoma

目的探讨适合高龄胃癌患者外科个体化治疗的方法。方法回顾性分析我院近10年来65例高龄胃癌患者的外科治疗。结果根治性手术34例,1年存活率73.5%,3年存活率41.2%,5年存活率23.5%;非根治性手术31例,1年存活率77.4%,3年存活率45.2%,5年存活率22.5%;术后辅助化疗38例,1年存活率71.1%,3年存活率42.1%,5年存活率23.7%;无辅助化疗27例,1年存活率81.5%,3年存活率48.1%,5年存活率22.2%。结论对高龄胃癌患者且存在耐受差、合并症多及晚期患者应强调治疗个体化,而不主张为求根治而扩大手术范围及术后辅助化疗。

Objective To discuss the individualized surgical treatment of elderly patiens with gastric carcinoma.Methods Results of surgical treatment of 65 cases with gastric carcinoma over 10 years from 1999-2008 were retrospectively analyzed.Results 34 cases were treated with radical resection(71.4%),with the one-,three-and five-year survival rates of 73.5%,41.2% and 23.5% respectively.31 cases received non-radical resection,with the one-,three-and five-year survival rates of 77.4%,45.2% and 23.7% respectively.38 cases experienced the postoperative adjuvant chemotherapy,with the one-,three-and five-year survival rates of 71.1%,42.1% and 23.7% respectively.27 cases without adjuvant chemotherapy,with the one-,three-and five-year survival rates of 81.5%,48.1% and 22.2% respectively.Conclusion Individualized surgical treatment of elderly patiens with gastric carcinoma should be performed according to the type of gastric carcinoma,the age of patients and the perfect operation;the postoperative adjuvant chemotherapy or extending the extent of dissection is not recommended.