晚期胃癌转化治疗后行手术干预的调查研究  

Investigation and research on surgical intervention after conversion therapy for advanced gastric cancer

作　　者：梁华元 谢青 孙孝文 陈新华 林填[2] 于莉娜[3] 陈曌[4] 余江[2] 胡彦锋[2] 赵丽瑛[2] 李国新[1] Liang Huayuan;Xie Qing;Sun Xiaowen;Chen Xinhua;Lin Tian;Yu Li'na;Chen Zhao;Yu Jiang;Hu Yanfeng;Zhao Liying;Li Guoxin(Department of Gastrointestinal Surgery,Beijing Tsinghua Changgung Hospital,School of Medicine,Tsinghua University,Beijing102218,China;Department of General Surgery,Nanfang Hospital,Southern Medical University,Guangzhou510515,China;Department of Pathology,Nanfang Hospital,Southern Medical University,Guangzhou510515,China;Department of Imaging,Nanfang Hospital,Southern Medical University,Guangzhou510515,China)

机构地区：[1]清华大学附属北京清华长庚医院胃肠外科,清华大学临床医学院,北京102218 [2]南方医科大学南方医院普通外科,广州510515 [3]南方医科大学南方医院病理科,广州510515 [4]南方医科大学南方医院影像科,广州510515

出　　处：《中华消化外科杂志》2024年第11期1430-1436,共7页Chinese Journal of Digestive Surgery

基　　金：北京市医院管理中心临床医学发展专项(ZLRK202519);四大慢病重大专项(2023ZD 0501500);北京市自然科学基金(L246012)。

摘　　要：目的调查晚期胃癌转化治疗后行手术干预的现状。方法采用回顾性横断面调查研究方法。2023年12月11—22日,以全国范围内161家医院中具备胃恶性肿瘤诊断与治疗资质的临床医师为调查对象,设计《晚期胃癌转化治疗后行手术干预的现况调查》问卷进行研究。问卷通过微信方式发放,软件平台为问卷星。计数资料以绝对数和百分比表示。结果(1)问卷调查结果。233位医师填写问卷,问卷回收率、问卷有效率均为100.00%(233/233)。(2)医师基本信息。233位医师中,男213位,女20位;年龄≤30岁、31~40岁、41~50岁、>50岁的医师分别为1、47、109、76位;外科、内科、放疗科、病理科医师分别为193、36、3、1位;主任医师、副主任医师、主治医师、住院医师分别为133、75、21、4位;执业年限>20年、11~20年、6~10年、≤5年分别为125、88、19、1位;工作单位属省级三级甲等综合医院、省级三级甲等肿瘤专科医院、地市级三级甲等综合医院、三级乙等及以下医院分别为102、58、59、14位。(3)晚期胃癌转化治疗情况。233位医师中,所在科室每年收治胃癌患者>100例的占比为54.94%(128/233),81.97%(191/233)的医师所在科室具有晚期胃癌转化治疗后手术切除经验;晚期胃癌转化治疗后成功行手术切除比例>5%的占比为66.52%(155/233),初诊行腹腔镜探查+腹腔冲洗脱落细胞学检查明确肿瘤分期比例≤10%的占比为51.50%(120/233)。(4)晚期胃癌转化治疗后策略选择。233位医师中,63.52%(148/233)的医师常规会向患者提及经转化治疗后可能再获手术机会;在晚期胃癌患者转化治疗后继续行姑息治疗可能存在的风险中选择肿瘤耐药、后续化疗免疫或者放疗等相关不良反应及远期毒性加重、远处转移器官进展占比分别为85.41%(199/233)、79.83%(186/233)、68.67%(160/233);晚期胃癌患者转化治疗后后续治疗选择多学科诊疗评估治疗策略、腔镜Objective To investigate the current status of surgical intervention after conversion therapy for advanced gastric cancer.Methods The retrospective cross-sectional investigation study was conducted.The investigation was conducted on clinicians who were qualified for the diagnosis and treatment of gastric cancer in 161 hospitals nationwide from December 11 to 22,2023.The questionnaire of"Survey on the Current Status of Surgical Intervention after Conversion Therapy for Advanced Gastric Cancer"was designed and distributed through WeChat based on the software platform of Wenjuanxing.Count data were expressed as absolute numbers and percentages.Results(1)Results of the questionnaire.Of the 233 clinicians,the percentage of completed questionnaires,recovered questionnaires,and valid questionnaires were all of 100.00%(233/233).(2)Basic information of clinicians.Of the 233 clinicians,there were 213 males and 20 females.The numbers of clinicians aged≤30 years,31-40 years,41-50 years,and>50 years were 1,47,109,and 76,respectively.The numbers of surgeons,internists,radiotherapists,and pathologists were 193,36,3,and 1,respectively.The numbers of chief physicians,deputy chief physicians,attending physicians,and resident physicians were 133,75,21,and 4,respectively.The numbers of clinicians with years of practice as>20 years,11-20 years,6-10 years,and≤5 years were125,88,19,and 1,respectively.The numbers of clinicians from provincial-level tertiary general hospitals,provincial-level tertiary specialized oncology hospitals,municipal-level tertiary hospitals,and tertiary hospitals of B and below were 102,58,59,and 14,respectively.(3)Conversion therapy of advanced gastric cancer.Of the 233 clinicians,there were 54.94%(128/233)of clinicians whose units had admitted more than 100 gastric cases per year,81.97%(191/233)of clinicians whose units had experience in surgical resection after conversion therapy of advanced gastric cancer,66.52%(155/233)of clinicians whose units had proportion of successful surgical resection after conve

关 键 词：胃肿瘤 晚期 转化治疗 手术干预 问卷调查 危险因素 腹腔镜检查 

分 类 号：R735.2[医药卫生—肿瘤]