进展期胃癌术前新辅助化疗对手术并发症的影响  

The influence of neoadjuvant chemotherapy on the complicaton of advanced gastric adenocarcinoma

作　　者：龚伟[1] 张勇[2] 施伟斌[1] 刘颖斌[2] 毕建威[3] 方国恩[3] 

机构地区：[1]第二军医大学长海医院 上海交通大学附属新华医院普外科,200000 [2]上海交通大学附属新华医院普外科,200092 [3]第二军医大学长海医院,200000

出　　处：《浙江临床医学》2011年第4期366-368,共3页Zhejiang Clinical Medical Journal

基　　金：上海市科委自然基金资助项目（张勇,04ZR1419800）

摘　　要：目的探讨局部进展期胃癌术前新辅助化疗对手术并发症的影响.方法 前瞻性收集2005年1月至2010年10月在上海交通大学新华医院进行新辅助化疗和胃癌根治术的142例局部进展期胃癌患者的资料,用Logistic回归分析方法对手术并发症的危险因素进行分析.结果 手术并发症38.0%（54/142）,死亡率1.4%（2/142）.年龄〉60岁[相对危险性11.3（95%CI：2.50~50.6）]及体重指数（BMI）≥26kg/m2[相对危险性4.08（95%CI：1.08~15.4）]是引起手术并发症的危险性因素.结论 术前新辅助化疗对局部进展期胃癌,并不是手术并发症和死亡率的危险因素.Objective Significant tumor downstaging has been achieved in patients with localized gastric adenocarcinoma and preoperative chemotherapy. However, the influence of preoperative chemotherapy on operative morbidity and mortality has not yet been clarified. The aim of the present study was to document the frequency and nature of morbidity and mortality after surgery combined with preoperative chemotherapy, and identify factors predictive of postoperative complications in patients with localized gastric adenocarcinoma. Methods A prospectively collected database of 142 consecutive patients who underwent preoperative chemotherapy at the Department of General Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine between January 2005 and October 2009 was reviewed. Postoperative morbidity and mortality were investigated, and risk factors for overall complications were identified by multivariate logistic regression analysis. Results Overall morbidity and mortality rates were 54 patients （38.0%） and 2 patients （ 1.4% ）, respectively. Age greater than 60 years [ relative risk 11.3 （ 95 % confidence interval 2. 50 -50. 6） ] and body mass index （BMI） of 26 kg/m2 or above [ relative risk 4. 08 （95% confidence interval 1.08 - 15.4） ] were significant risk factors for overall complications. Conclusions Preoperative chemotherapy can be performed safely with an acceptable operative morbidity and a low operative mortality rate in patients with gastric cancer, with careful consideration of added risk associated with age and obesity.

关 键 词：进展期胃癌 新辅助化疗 并发症 死亡率 

分 类 号：R737.33[医药卫生—肿瘤]