第四期胃癌转换手术的预后因素:一个多机构的回顾性分析
Atsushi Takeno1, Masaaki Motoori2, Kentaro Kishi3
1Department of Surgery, National Hospital Organization Osaka National Hospital Osaka Japan.
Annals of gastroenterological surgery
|May 6, 2024
概括
对于第四阶段的晚期胃癌 (AGC) 的转化手术 (CS) 可以提高存活率,如果实现R0切除. 病态T4和N阳性是这些患者R0切除的不良预后因素.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 第四阶段的晚期胃癌 (AGC) 提出了重大治疗挑战.
- 转换手术 (CS) 是对化学治疗有反应的AGC患者的潜在策略.
- 在CS中成功的R0切割的预测者对于IV阶段的AGC需要进一步澄清.
研究的目的:
- 评估CS在IV期AGC的临床结果.
- 确定影响CS期间R0切除的预后因素,用于IV期AGC.
- 根据转移模式分析结果.
主要方法:
- 对210名接受CS治疗的IV阶段AGC患者 (2007-2017) 的回顾性分析.
- 数据收集包括患者背景,手术前治疗,手术结果和生存率.
- 用R0切除患者的单变量和多变量分析评估了整体和无复发生存的预后因素.
主要成果:
- 在70%的患者中实现了R0切除,平均存活32个月 (3年存活:45%).
- 与R1/2切除相比,R0切除显著改善了存活率 (41.5 vs 20.7个月).
- 病态N阳性和T4状态独立预测R0切除患者的整体和无复发生存率较差.
结论:
- 实现R0切除的CS为IV期AGC患者提供了延长的生存期.
- 患有病态T4和N阳性的患者可能会从R0切除后的强化辅助疗法中受益.
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