胃癌术后复发的相关因素及再手术治疗

The correlation factors and reoperation for recurrence of gastric carcinoma after gastrectomy

目的 探讨胃癌术后复发的相关因素,再手术的适应证及其临床效果.方法 回顾性分析2003年7月-2010年7月收治的、行根治性手术的362例胃癌患者临床资料.对胃癌术后复发的相关因素做统计学分析,并探讨再手术治疗的适应证及其临床效果.结果 362例中,161例术后复发,102例行再手术治疗.再手术的术式为根治术50例,姑息性手术34例,剖腹探查术18例.术后随访15天～60个月,采用3种术式术后患者的中位生存时间分别为22.6、11.7和4.4个月.患者年龄、性别、肿瘤生长的部位与胃癌术后复发无明显相关.而术前肿瘤大小、组织学分化程度、淋巴结转移情况、淋巴结清扫范围、手术方式、肿瘤分期、肿瘤浸润深度、术后是否化疗与胃癌术后复发显著相关,P均＜0.05.结论 多种因素可以影响胃癌手术后复发.再手术治疗能提高复发性胃癌患者的生存率.

Objective To investigate relevant factors of recurrence of gastric cancer, indications and clinical effects of re-operation. Methods 362 cases of gastric carcinoma in Yixing people＇s hospital from July 2003 to July 2010 were reviewed by retrospective study. All of patients had been operated radically. Than we analyzed relevant factors of recurrence of gastric cancer, indications and clinical effects of re-operation. Results In 362 eases, 161 eases had relapsed, in them, 102 cases re-operated by radical gastrectomy（50 cases） , palliative surgery（34 cases） and laparotomy （18 cases）. The median survival time of these 3 surgical was 22.6, 11. 7 and 4.4 months. Relevant factors of recurrence of gastric cancer were tumor size, degree of differentia- tion, stage, depth of invasion, lymph node metastasis, lymph node dissection, surgical style, postoperative chemotherapy（P 〈 0.05）. Conclusions Many factors can affect the postoperative recurrence of gastric cancer. Re-operation can improve survival for patients who gastric cancer relapse.