摘要
目的:采用两种不同的治疗模式,探究胃癌同时性肝转移的临床疗效。方法:回顾性分析24例胃癌同时性肝转移患者的临床资料,分为转化治疗组与单纯手术组。其中转化治疗组(11例)患者在多学科诊疗的引领下先进行化疗,然后行胃癌治愈性手术(R0或R1),术后继续化疗;单纯手术组(13例)患者行胃癌切除术(R0或R1),术后继续化疗。两组患者全部随访,随访日期截止为2020年8月,中位随访时间为50(37~67)个月。结果:转化治疗组和单纯手术组共24例患者均顺利完成手术,无术后并发症。两组患者的累积生存率比较,差异具有统计学意义(P=0.026<0.05)。进一步分析发现:R0切除13例患者较R1切除11例患者,平均生存时间更长,两组比较差异具有统计学意义(P=0.000<0.05)。结论:胃癌同时性肝转移转化治疗可以提高患者的生存期,R1切除是预后不良的独立危险因素。
Objective To investigate the clinical efficacy of two different therapeutic models for simultaneous liver metastasis of gastric cancer.Method The retrospective cohort study was conducted.The clinical data of 24 patients with simultaneous liver metastasis of gastric cancer were collected.They were divided into conversion therapy group and simple operation group.Among them,11 patients in the conversion therapy group were treated with chemotherapy under the guidance of multi-disciplinary treatment,then underwent curative gastric cancer surgery(R0 or R1),followed by chemotherapy,while 13 patients in the simple operation group were treated with gastrectomy(R0 or R1)plus postoperative chemotherapy.All patients in both groups were followed up until August 2020,and the median follow-up time was 50(37~67)months.Results All the 24 patients in the conversion therapy group and the simple operation group were cured without postoperative complications.The 3-year cumulative survival rates of patients in the conversion treatment group and the simple operation group were compared.The difference between the two groups was statistically significant(P=0.026<0.05).Further analysis found that the 3-year cumulative survival rate of 13 patients with R0 resection was longer than that of 11 patients with R1 resection(P=0.000<0.05).Conclusion Conversion therapy can improve the survival time of patients with simultaneous liver metastasis of gastric cancer,and R1 resection is an independent risk factor for poor prognosis.
作者
章含昀
邹兵兵
余昌俊
ZHANG Han-yun;ZOU Bing-bing;YU Chang-jun(Department of General Surgery(Department of Gastrointestinal Surgery),the First Affiliated Hospital of Anhui Medical University,Anhui 230022,China)
出处
《吉林医学》
CAS
2021年第6期1307-1311,共5页
Jilin Medical Journal
基金
安徽省教育厅质量工程项目[项目编号:2016jyxm0538]
安徽高校自然科学研究项目[项目编号:KJ2019A0249]。
关键词
胃癌同时性肝转移
转化治疗
外科手术
化疗
Simultaneous Liver Metastasis of Gastric Cancer
Conversion therapy
Surgical procedures
Chemotherapy
