胃癌术后复发转移部位规律及对放疗靶区设计的意义

Recurrence of Gastric Cancer Metastasis Site and Implication to the Design of Radiation Therapy Target

目的通过了解胃癌根治术(D2根治术)后的局部复发转移规律以确定术后辅助放疗照射,为术后进一步治疗提供指导。方法回顾我院由病理诊断为胃癌并行D2根治术后,随访经CT或MRI确诊出现复发转移的60例患者。对其术后复发区域资料进行统计分析。结果局部复发吻合口、残胃(12/48)、腹腔淋巴结(41/48)、肝脏(11/48)、肺转移(6/48)、盆腔种植(4/48)、其他部位转移(12/48)。有41例出现腹腔淋巴结转移,其中局部复发7例。结论胃癌根治术后肿瘤复发部位与原发部位相关,最常见的转移部位为腹膜后淋巴结,且以胃体及胃窦部癌常见。

ObjectiveBy understanding （D2 radical prostatectomy） of local recurrence after gastric cancer radical transfer rule to determine the postoperative adjuvant radiation exposure, guidance for further treatment after surgery.MethodsReview the pathological diagnosis for the parallel D2 gastric cancer radical surgery and follow-up CT or MRI diagnosis of recurrence metastasis, 60 cases occurred. Statistical analysised postoperative recurrence of regional data. ResultsThe local anastomotic recurrence in the stomach （12/48）, abdominal lymph nodes （41/48）, liver （11/48）, pulmonary metastasis （6/48）, pelvic planting （4/48）, other parts of the transfer （12/48）. There were 41 cases with abdominal lymph node metastasis, including 7 cases of local recurrence.ConclusionThe gastric cancer radical surgery tumor recurrence partly related to the primary site, the transfer of the most common site is retroperitoneal lymph nodes, gastric body and gastric antrum cancer is also common.