期刊文献+

残胃癌的外科治疗与预后分析 被引量:7

Surgical treatment and prognosis of gastric stump cancer
下载PDF
导出
摘要 背景与目的:残胃癌具有独特的生物学活性,外科治疗复杂,预后差。本研究主要探讨残胃癌的临床特点、治疗方法对远期生存率的影响,分析影响预后的因素。方法:回顾性分析浙江省肿瘤医院1990年1月至2007年12月收治的81例残胃癌的临床资料。用Kaplan-Meier法进行生存分析,用Cox回归模型进行多因素分析。结果:81例残胃癌中,根治性手术切除治疗47例,非根治性治疗(包括姑息性切除术、短路或造瘘术及探查术)34例,根治手术切除率为58.0%。全组1、3、5年总生存率分别为69.1%、24.3%、11.8%。根治组患者1、3、5年生存率分别为93.6%、42.0%、20.8%,非根治组1、3、5年生存率分别为35.3%、5.9%、0%,两组相比差异有统计学意义(P<0.05)。Cox多元回归分析显示,残胃癌术后生存率与肿瘤的病理类型、病期、根治情况、腹膜种植、肝转移等因素有关。结论:合理的根治性手术可提高残胃癌患者的生存率。肿瘤的病理类型、TNM分期、根治情况、腹膜种植、肝转移是影响预后的独立因素。 Background and Objective. Gastric stump cancer (GSC) has unique biological behaviors and poor prognosis. The surgical treatment for GSC is complex. This study was to explore the clinical characteristics of GSC and the effect of operation patterns on long-term survival, and investigate its prognostic factors. Methods. The clinical data of 81 GSC patients, treated in Zhejiang Cancer Hospital from January 1990 to December 2007, were analyzed. Patients' survival was analyzed by Kaplan-Meier method~ the prognosis was analyzed by Cox multivariate regression model. Results: Of the 81 patients, 47 (58.0%) received radical resection, 34 received non-radical operation (including palliative operation, short circuit or fistulation and exploration). The overall 1-, 3-, and 5-year survival rates were 69.1%, 24.3%, and 11.8% in the whole group. The 1-, 3-, and 5-year survival rates were significantly higher in radical resection group than in non-radical operation group (93.6% vs. 35.3%, 42.0% vs. 5.9%, 20.8% vs. 0, P〈0.05). Cox multivariate regression analysis showed that clinical stage, pathologic classification, radical resection, peritoneal seeding and liver metastasis were related with the survival of GSC patients. Conclusions: Radical resection may help to improve the prognosis of GSC. Clinical stage, pathologic classification, radical resection, peritoneal seeding and liver metastasis are independent prognosis factors of GSC.
出处 《癌症》 SCIE CAS CSCD 北大核心 2009年第5期511-514,共4页 Chinese Journal of Cancer
关键词 残胃肿瘤 临床特征 外科手术 预后 gastric stump neoplasm, clinical feature, surgical operation, prognosis
  • 相关文献

参考文献10

  • 1Khushalani N. Cancer of the esophagus and stomach [J]. Mayo Clin Proc, 2008,83 (6) : 712-722.
  • 2Thorbans S, Bottcher K, Etter M, et al. Prognostic factors in gastric stump carcinoma [J]. Ann Surg, 2000,231 (2):188- 194.
  • 3Ahn HS, Kim JW, Yoo MW, et al. Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy [J]. Ann Surg Oncol, 2008,15 (6): 1632-1639.
  • 4许东奎,赵平,王成锋,邵永孚,蔺宏伟,田艳涛.残胃癌的临床病理特征及预后分析[J].中华肿瘤杂志,2006,28(11):852-854. 被引量:25
  • 5Fukuhara K, Osugi H, Takada N, et al. Quantitative determinations of duodenogastric reflux, prevalence of Helicobacter pylori infection, and concentrations of interleukin- 8 [J]. World J Surg, 2003,27(5) :567-570.
  • 6Takeuchi K, Ohno Y, Tsuzuki Y, et al. Helicobacter pylori infection and early gastric cancer [J]. J Clin Gastroenterol, 2003,36 (4) : 321-324.
  • 7陈力,田华,何志刚,陶思丰,彭淑牖.37例残胃癌患者外科治疗的预后分析[J].中华胃肠外科杂志,2004,7(3):208-210. 被引量:14
  • 8Ogoshi K, Okamoto Y, Nabeshima K, et al. Focus on the conditions of resection and reconstruction in gastric cancer. What extent of resection and what kind of reconstruction provide the best outcomes for gastric cancer patients? [J]. Digestion, 2005,71(4) :213-224.
  • 9Schaefer N, Sinning C, Standop J, et al. Treatment and prognosis of gastric stump carcinoma in comparison with primary proximal gastric cancer [J]. Am J Surg, 2007,194( 1 ) :63-67.
  • 10An JY, Youn HG, Ha TK, et al. Clinical significance of tumor location in remnant gastric cancers developed after partial gastreetomy for primary gastric cancer [J]. J Gastrointest Surg, 2008,12(4) :689-694.

二级参考文献24

  • 1陈峻青 张文范 等.残胃再发癌的诊断与外科治疗[J].中华肿瘤杂志,1984,6(4):300-300.
  • 2Pointner R,Wetscher GJ,Gadenstatter M,et al. Gastric remnant cancer has a better prognosis than primary gastric cancer. Arch Surg, 1994, 129:615-619.
  • 3Thorban S,Bottcher K,Etter M,et al. Prognostic factors in gastric stump carcinoma. Ann Surg, 2000, 231:188-194.
  • 4Takeda J,Hashimoto K,Koufuji K,et al. Remnant-stump gastric cancer following partial gastrectomy. Hepatogastroenterology, 1992,39:27-30.
  • 5Fukuhara K,Osugi H,Takada N,et al. Quantitative determinations of duodenogastric reflux,prevalence of Helicobacter pylori infection,and concentrations of interleukin-8. World J Surg, 2003, 27:567-570.
  • 6Kaneko K,Kondo H,Saito D,et al. Early gastric stump cancer following distal gastrectomy. Gut, 1998, 43:342-344.
  • 7Ereene FL. Management of gastric remnant carcinoma based on the results of a 15-year endoscopic screening program. Ann Surg, 1996, 223:701-706.
  • 8Doglietto GB,Pacelli F,Caprino P,et al. Surgery:independent prognostic factor in curable and far advanced gastric cancer. World J Surg, 2000, 24:459-463.
  • 9Kunisaki C,Shimada H,Nomura M, et al. Lymph node dissection in surgical treatment for remnant stomach cancer. Hepatogas-troenterology, 2002, 49:580-584.
  • 10Pointner R, Wetscher GJ, Gadenstatter M, et al. Gastric remnant cancer has a better prognosis than primary gastric cancer. Arch Surg,1994, 129:615-519.

共引文献35

同被引文献95

引证文献7

二级引证文献15

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部