高龄胃癌的诊断与外科治疗(附56例报告)

The diagnosis and surgical treatment of gastric cancer in elderly patients:a report of 65 cases

目的探讨高龄胃癌的临床病理特征,旨在提高手术切除率,改善其预后。方法对我院2000年12月至2005年12月间收治的56例高龄胃癌病例进行回顾分析。结果本组56例均为进展期胃癌;并存其他疾病47例(83.9%);原发癌位于胃底或贲门部26例(46.4%);肿块直径大于3cm41例(73.2%);伴淋巴结转移43例(76.8%);高、中分化腺癌45例(80.4%);手术切除率为85.7%,其中根治性切除率55.2%;并发症发生率为33.9%;3年生存率为55.4%,5年生存率为37.5%。结论早期诊断、选择合理的手术方式、术前积极处理伴发病及加强术后护理是改善老年胃癌患者预后的关键。

Objective To explore the clinicopathological features of gastric cancer in the elderly so as to increase resection rate and improve the prognosis. Methods Fifty - six elderly patients with gastric cancer in our hospital from Dec. 2000 to Dec. 2005 were analyzed retrospectively. Results Among 56 patients, all cases were diagnosed as advanced gastric cancer;Most of them suffered from other diseases （83.9 % ） ; Primary site located in fundus or cardia in 26 cases （46.4 % ） ; The diameter of the tumor was over 3 cm in 41 cases （73.2%） ;Metastatic rate of lymph node was 76.8% ;There were 43 cases of high and middle differentiated ad （80.4 % ） ;The resection rate was 85.7 % and radical resection rate was 55.2 % ; The 3 - and 5 - year survival rate was 55.4 % and 37.5 % respectively. Conclusion Earlier diagnosis, reasonable operative methods and the attentive treatment for the operative associated diseases are the significant factors to increase the survive rate of the gastric cancer in the elderly.