摘要
目的探讨75岁及以上老年胃癌患者是否应接受手术治疗以及手术应采用何种术式。方法回顾性分析2005年1月至2009年12月间，76例活动状态评分小于4分且可行根治性手术的胃癌患者。将其分为手术治疗组和支持治疗组；手术组又分为DO（未行胃周淋巴结清扫）＋D1（清扫胃周淋巴结，总数大于15枚）手术组和D2（清扫伴随腹腔血管周围淋巴结，总数大于15枚）手术组，对各组临床资料、治疗和生存情况进行分析。结果手术治疗组5年生存率36．4％，而支持治疗组3年生存率为0％；DO＋D1手术组和D2手术组的并发症发生率差异无统计学意义；淋巴廓清数D2手术组为（27．4±12．8）个，在DO＋D1手术组为（14．6±12．1）个（t=-4．095，P=0．000）；5年生存率D2手术组（47．3％）高于DO＋D1手术组（18．5％）（P=0．0]0）。结论老年胃癌患者可以从根治手术中获益，标准D2根治手术在75岁及以上的老年患者依然是适宜的手术方式。
Objective To investigate whether gastric resection is feasible for the patients aged 75 years and over and which surgery type should be taken in elderly patients. Methods 76 gastric cancer patients undergoing radical surgery with performance status score less than 4 were reviewed retrospective[y from 2005 to 2009. 63 cases underwent curative resection, in which 32 cases had DO or D1 lymph node dissection and 31 cases had D2 lymph node dissection, and 13 cases received best supportive care. The dissected lymph nodes, morbidity, mortality and long-term survival rate in the two groups were analyzed. Results 5-year survival rate was 36.4% in curative resection group, and 3-year survival rate was 0% in supportive group. There was no significant difference in surgery complications between the DO ＋ D1 group and the D2 group. The number of dissected lymph nodes was more in D2 group than in D0＋D1 group [（27.4±12.8） vs. （14.6± 12.1）, t= -4. 095,P〈 0. 001）. 5-year survival rate was higher in D2 group than in D0＋D1 group（47.3% vs. 18.5%, P〈 0.05）. Conclusions Curative resection of gastric cancer and standardized D2 lymph node dissection is suitable and beneficial for the elderly patient .
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2014年第2期189-191,共3页
Chinese Journal of Geriatrics
关键词
胃肿瘤
外科手术
Stomach neoplasms l Surgical procedures
