对于早期胃癌的功能维护性治疗性胃切除术的长期生存预后
Shinichi Kinami1, Daisuke Kaida1, Koichi Okamoto1
1Department of Surgical Oncology, Kanazawa Medical University, Kahoku, Ishikawa 920-0293, Japan.
Oncology letters
|February 2, 2024
概括
与指导性胃切除术 (GL) 相比,功能维护性胃切除术 (FPG) 为早期胃癌患者提供了更好的生存率和更少的非癌症死亡. 哨兵节点活检 (SNB) 指导FPG,改善结果.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 功能维护性胃切除术 (FPG),如细分胃切除术,对于早期的胃癌来说是不那么侵入性的选择.
- 与标准指南胃切除术 (GL) 相比,它们对长期生存的影响需要进一步调查.
研究的目的:
- 为了比较患有结节阴性早期胃癌的患者的生存预后,用FPG治疗和减少淋巴结剖析与GL相比.
- 在两组治疗中评估非癌症相关死亡率.
主要方法:
- 对pT1N0早期胃癌患者 (类型0,≤5厘米,L或M区域) 的回顾性研究 (1999-2016).
- 使用哨兵节点活检 (SNB) 和减少淋巴结剖析的FPG与GL (远程胃切除术,胆管保护性胃切除术) 的比较.
- 倾向性得分匹配分析被用来调整潜在的混因素.
主要成果:
- 与GL组相比,FPG组在5年 (96.6%) 和10年 (92.5%) 的整体存活率 (OS) 显著更高 (P<0.05).
- 非癌症相关死亡的累计发病率,特别是肺部疾病,在FPG组明显较低 (P<0.05).
- 在这两组中,复发是罕见的,在GL组中只有一个事件.
结论:
- 对于L或M区域的早期胃癌,SNB指导的FPG提供了优越的预后,并降低了与GL相比的非癌症死亡率.
- FPG与更好的长期存活和较少的呼吸系统疾病相关死亡有关.
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