摘要
目的探讨转移性胃癌的临床病理特征及转化治疗效果。方法回顾性分析2018年1月至2021年6月北京大学人民医院胃肠外科确诊并治疗的31例转移性胃癌患者的临床病理及随访资料。采用多因素Logistic回归分析病理完全缓解与临床病理特征的相关因素,并用Kaplan-Meier生存曲线分析转移性胃癌分型与术后病理缓解程度对患者预后的影响。结果本组31例患者中肿瘤位于贲门胃底部13例,胃体部8例,幽门胃窦部10例。有10例术前影像学评价为腹膜后淋巴结转移,腹腔种植转移10例,肝转移2例,肾上腺和脾转移各1例,多发转移5例。转化治疗术后病理有8例(26%)原发灶完全缓解(pT0),16例(52%)区域淋巴结完全缓解(pN0),7例(22%)病理完全缓解。多因素Logistic回归分析显示,腹膜后淋巴结转移(OR:20.082,95%CI:2.141~188.315,P=0.009)是病理完全缓解的独立影响因素。pT0可以显著改善无疾病生存时间(P=0.021)。结论转移性胃癌中单纯腹膜后淋巴结转移患者的转化治疗效果较好,pT0是改善患者预后的重要因素。
Objective To investigate clinicopathological characteristics and efficacy of conversion therapy in patients with metastatic gastric cancer.Methods The clinicopathological and follow-up data of metastatic gastric cancer patients at the Department of Gastrointestinal Surgery of Peking University People's Hospital from Jan 2018 to Jun 2021 were retrospectively studied.Multivariate Logistic regression analysis was used to identify independent characteristics for pathological complete response(PCR).The influence of stage of metastatic gastric cancer and pathological response on prognosis were analyzed by Kaplan-Meier curve.Results A total of 31 patients were enrolled,and 13 tumors located at the cardia or fundus,8 at body,other 10 at pylorus or antrum.Baseline CT evaluation showed retroperitoneal lymph node metastasis in 10 cases,intraperitoneal metastasis in 10 cases,liver metastasis in 2 cases,adrenal and splenic metastasis in 1 case respectively,and multiple metastasis in 5 cases.After conversion therapy,8(26%)cases had pathological T0,16 cases(52%)had pathological N0 and 7 cases(22%)had pathological complete response.Multivariate Logistic regression analysis showed retroperitoneal lymph node metastasis(OR:20.082,95%CI:2.141-188.315,P=0.009)was the only independent risk factor of PCR.Meanwhile,Kaplan-Meier curve showed pT0 improved disease-free survival significantly(P=0.021).Conclusions Metastatic gastric cancer patients with retroperitoneal lymph node metastasis alone had a tolerable conversion therapy effect.pT0 is a significant factor in improving prognosis.
作者
王超
高志冬
沈凯
申占龙
姜可伟
梁斌
周静
叶颖江
Wang Chao;Gao Zhidong;Shen Kai;Shen Zhanlong;Jiang Kewei;Liang Bin;Zhou Jing;Ye Yingjiang(Department of Gastrointestinal Surgery,Peking University People's Hospital,Beijing 100044,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2022年第8期561-566,共6页
Chinese Journal of General Surgery
基金
北京大学人民医院研究与发展基金(RDY2019-27)。
关键词
胃肿瘤
淋巴转移
预后
转化治疗
Stomach neoplasms
Lymphatic metastasis
Prognosis
Conversion therapy
