32例化疗后接受手术治疗的晚期胃癌患者的临床分析

Clinical analysis of 32 metastatic gastric cancer patients who underwent surgery after chemotherapy

目的：对晚期胃癌一线化疗后接受手术治疗的患者进行分析，寻找影响该组患者生存的因素。方法：回顾性分析2007年8月至2011年7月32例一线化疗后接受手术治疗的晚期胃癌患者的资料，分析多种临床病理因素对生存的影响。生存分析采用Kaplan-Meier法，并以Log-rank法比较组间差异，应用Cox模型进行多因素分析。结果：全组患者中位年龄46岁（22—74岁），中位生存期为19个月（4～59个月）。生存分析显示化疗疗效（PR，SD患者分别为23个月和14．5个月，P=0．045）和原发灶是否切除（切除，未切除患者分别为23个月和5．5个月，P=0．017）与总生存相关。多因素分析未显示单一的因素与患者的生存相关。结论：化疗有效、原发病灶可切除的经过选择的晚期胃癌患者，可以尝试进行原发病灶的手术治疗。

Objective： To examine metastatic gastric cancer patients who underwent surgery after chemotherapy and to determine the factors affecting survival. Methods： Clinical data on metastatic gastric cancer patients who underwent surgery after chemotherapy were retrospectively analyzed. The overall survival data were evaluated through the Kaplan-Meier method, Log-rank test, and Cox haz- ards regression. Results： The median age was 46 （22 - 74）, and the median overall survival rate （OS） was 19 months （4 - 59 months）. Response to chemotherapy （23.0 m for PR and 14.5 m for SD, P=0.045） and resection of the primary tumor （23.0 and 5.5 m, respectively, P=0.017） affected OS. No single factor was related to OS according to Cox regression. Conclnsion： Surgical removal of the primary tumor is recommended for metastatic gastric cancer patients with positive response to chemotherapy and with a primary tumor that can be resected.