联合脏器切除治疗T4b期胃癌的临床疗效分析  

Clinical analysis of combined organ resection for T4b gastric cancer

作　　者：蔡明志[1] 梁寒[1] 王晓娜[1] 张李[1] 吴亮亮[1] 

机构地区：[1]天津医科大学附属肿瘤医院胃部肿瘤科天津市肿瘤防治重点实验室,300060

出　　处：《中华胃肠外科杂志》2012年第5期502-504,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价联合脏器切除术治疗T4b期胃癌的治疗效果。探讨其手术适应证及预后影响因素。方法回顾性分析2001—2005年间在天津医科大学附属肿瘤医院接受联合脏器切除治疗的96例T4bN0-3bM0期胃癌患者的临床和随访资料。结果12例（12．5％）患者出现术后并发症，其中胰瘘4例，腹腔感染5例，肺部感染3例；均经保守治疗后治愈，全组未出现围手术期死亡病例。全组患者均获随访，中位随访时间为73个月，术后1、3和5年生存率分别为70．5％、42．1％和23．5％。单因素预后分析显示，Borrmann分型、病理类型、淋巴结分期及胰腺侵犯与TAb期胃癌患者的生存有关（均P〈O．05）：多因素预后分析显示，淋巴结分期和病理类型是本组‘I曲期胃癌的独立预后因素（均P〈0．05）。结论淋巴结分期为pN0或pN，的高分化T4bM。期胃癌患者，在接受根治性联合脏器切除后可获得较好的预后。Objective To evaluate the outcomes of combined organ resection for T4b gastric cancer, and determine the operative indication and prognostic factors. Methods Clinical data of 96 cases with T4bN0-3bM0 gastric cancer treated with combined organ resection in Tianjin Cancer Hospital from 2001 to 2005 were analyzed retrospectively. Results Twelve patients developed postoperative complications, including pancreatic fistula（n=4）, abdominal infection（n=5）, pulmonary infection（n=3）, all of which were managed with conservative treatment. There were no perioperative deaths. All the patients had postoperative follow up with a median of 73 months. The 1-, 3-, 5-year overall survival rates were 70.5%, 42.1%, and 23.5%, respectively. Univariate analysis showed that Borrmann type, histologic type, lymph node staging, and pancreatic invasion were associated with the survival in patients with T4b gastric cancer （both P〈0.05）. Multivariable analysis showed that lymph node staging and histologic type were independent prognostic factors （all P〈0.05）. Conclusion For well differentiated gastric cancer with lymph node staging of pN0 or pN1, combined organ resection may offer survival benefit.

关 键 词：胃肿瘤 T4b期 联合脏器切除术 预后 

分 类 号：R735.2[医药卫生—肿瘤]