多学科团队模式下腹腔脱落细胞学阳性晚期胃癌患者的诊疗策略

Diagnosis and treatment strategy for advanced gastric cancer with positive peritoneal lavage cytology in multidisciplinary team model

目的:介绍1例多学科团队模式(multiple discipline team, MDT)下腹腔脱落细胞学阳性晚期胃癌患者的诊治经过,探讨同类患者的MDT诊疗策略。方法:患者入院后诊断为腹腔脱落细胞阳性晚期胃癌,cT_(4a)N(+)M_1(CY_1),经MDT讨论后,考虑予以转化化疗联合根治手术治疗。结果:经积极全身治疗后,患者接受胃癌根治手术,术后予单药辅助化疗。患者随访期间出现腹腔转移,予姑息化疗,2018年6月仍生存。结论:该病例诊治经过提示,MDT模式有助于对胃癌患者制定最优治疗方案,获得最佳治疗效果。胃癌腹腔脱落细胞学阳性胃癌患者可通过外科手术联合化疗取得最大生存获益。

Objective:To describe the multidisciplinary team(MDT) diagnosis and treatment process for one case of advanced gastric cancer with positive peritoneal lavage cytology, in order to explore the diagnosis and treatment strategies for advanced gastric cancer with positive peritoneal lavage cytology. Methods:The patient was newly diagnosed as gastric cancer with positive peritoneal lavage cytology. The patient was performed conversional chemotherapy and the following radical resection. Results:The patient underwent radical gastrectomy after successfully systematic chemotherapy and adjuvant single agent. The patient developed peritoneal metastasis in the follow-up but achieved long -term survival until now through palliative chemotherapy therapy. Conclusions: It is showed that MDT system can provide optimal treatment strategy to gastric cancer and help patients to acquired the best therapeutic effect. For gastric cancer patient with positive peritoneal lavage cytology, effective conversion chemotherapy with followed radical operation often leads to great survival benefit.