摘要
目的探讨新辅助化疗能否预防胃癌根治术后并发症导致的不良预后。方法回顾性分析2009年1月至2016年12月云南省第三人民医院新辅助化疗联合胃癌根治术病人157例及直接行胃癌根治术病人139例。比较新辅助化疗联合胃癌根治术组中有并发症和无并发症病人的总体生存率和无复发生存率。结果在直接行胃癌根治术的病人中,并发症的发生率为48.20%高于联合新辅助化疗病人的35.03%(χ^2=5.278,P=0.022)。157例新辅助化疗联合胃癌根治术病人中有55例(35%)出现2级以上并发症。在有并发症的病人中,3年总体生存率、3年无复发生存率分别为64.61%和43.55%,而对于无并发症病人,3年总体生存率、3年无复发生存率分别为68.26%和48.78%,有并发症病人与无并发症病人的预后差异无统计学意义。在多因素分析中,肿瘤退缩分级与总体存活率和无复发生存率差独立相关(P=0.030)。结论新辅助化疗可减少胃癌根治术病人术后并发症的发生率,且可减少胃癌根治术后并发症所导致的不良预后;肿瘤新辅助治疗后的退缩反应对病人的预后有显著影响,能指导术后辅助治疗方案的选择。
Objective To investigate whether neoadjuvant chemotherapy can prevent adverse prognosis caused by complications after radical gastrectomy for gastric cancer.Methods The clinical data of 157 cases of neoadjuvant chemotherapy combined with radical gastrectomy and 139 cases of direct radical gastrectomy from January 2009 to December 2016 were retrospectively analyzed.To compare the overall survival rate and recurrence-free survival rate of patients with complications and without complications in neoadjuvant chemotherapy combined with radical gastrectomy for gastric cancer.Results The incidence of complications in patients undergoing radical gastrectomy was higher than that in patients receiving neoadjuvant chemotherapy(48.20%vs.35.03%,χ^2=5.278,P=0.022).Among 157 cases of neoadjuvant chemotherapy combined with radical gastrectomy,55 cases(35%)had grade 2 or more complications.In patients with complications,the 3-year overall survival rate and 3-year recurrence-free survival rate were 64.605%and 43.552%,respectively.For patients without complications,the 3-year overall survival rate and 3-year recurrence-free survival rate were 68.255%and 48.770%,respectively.There was no significant difference in the prognosis between patients with complications and patients without complications.In multivariate analysis,regression grade was independently correlated with overall survival and poor relapse-free survival(P=0.030).Conclusion This study shows that neoadjuvant chemotherapy can reduce the incidence of complications after radical gastrectomy and the adverse prognosis caused by complications after radical gastrectomy.The retraction reaction after neoadjuvant therapy has a significant impact on the prognosis of patients,and can guide the choice of adjuvant therapy after radical gastrectomy.
作者
殷芳
郭致平
YING Fang;GUO Zhiping(Department of Gastroenterology,the Third People’s Hospital of Yunnan Province,Kunming,Yunnan 650000,China)
出处
《安徽医药》
CAS
2020年第11期2267-2272,共6页
Anhui Medical and Pharmaceutical Journal
