T3-4期胃癌术中腹腔化疗回顾性研究  

Retrospective study of intra-peritoneal chemotherapy for T3-4 gastric cancer

作　　者：魏哲威[1] 张常华[1] 夏光概[1] 吴英[1] 何裕隆[1] 

机构地区：[1]中山大学附属第一医院胃肠胰外科,广东广州510080

出　　处：《中国实用外科杂志》2013年第6期504-508,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(30700805;81272643);中山大学5010项目(20100816);中山大学青年培育项目(09ykpy49)

摘　　要：目的探讨进展期胃癌术中腹腔化疗的临床价值。方法回顾性分析2008年1月至2011年3月期间在中山大学附属第一医院行根治性手术联合术中腹腔化疗的86例T3-4期胃癌病人临床病理资料和预后,并与同期行根治性手术未联合术中腹腔化疗的245例T3-4期胃癌病人进行比较,研究术中腹腔化疗对胃癌病人围手术期并发症、复发和预后的影响。结果联合术中腹腔化疗组手术并发症发生率明显高于未联合腹腔化疗组(5.8%vs.1.2%,P=0.048)。联合腹腔化疗组复发率为18.6%(16/86),对照组复发率为12.2%(30/245),两组差异无统计学意义(P=0.142)。2年的总存活率术中腹腔化疗组为64.0%,与对照组的63.4%比较差异无统计学意义(P=0.742)。Cox回归分析结果显示术中腹腔化疗并非胃癌病人的独立预后因素(HR=0.918,P=0.742)。结论胃癌术中腹腔化疗有增加手术并发症的风险,对术后复发和预后的影响需进一步研究。Objective To evaluate efficacy of intra-peritoneal chemotherapy for advanced gastric cancer. Methods Between January 2008 and March 2011, patients with T3-4 gastric cancer who were performed radical dissection only （non-IOC group, n=245） or radical dissection plus intra-peritoneal chemotherapy （IOC group, n=86） in the First Affiliated Hospital of Sun Yat-Sen University, were retrospectively enrolled in this study. Clinicopathological characteristics and survival status were compared between the two groups. Results Postoperative complications occurred in 5.8 % patients in the IOC group which was significantly higher than that in the non-IOC group （p=0.048）. Recurrence rate was 18.6% in the IOC group and 12.2% in the non-IOC group （p=0.142）. Two-year overall survival in the IOC group was 64.0% which was similar to that in the non-IOC group （63.4%, p=0.742）. Multivariate analysis showed that intra-peritoneal chemotherapy was not an independent prognostic factor for gastric cancer patients （HR= 0.918, P=0.742）. Conclusions Intra-peritoneal chemotherapy may be related to increasing postoperative complications while its effect on recurrence and prognosis should be further investigated.

关 键 词：胃癌 术中腹腔化疗 预后 并发症 

分 类 号：R6[医药卫生—外科学]