85岁以上的胃癌患者的预后因素
Shunji Endo1, Masaharu Higashida2, Kei Furuya2
1Department of Digestive Surgery, Kawasaki Medical School, 577, Matsushima, Kurashiki, 701-0192, Okayama, Japan. endo-s@med.kawasaki-m.ac.jp.
BMC cancer
|June 18, 2024
概括
对于老年胃癌患者 (≥85岁),远部胃切除术提供了比没有手术更好的生存率. 然而,由于肺炎的高风险,应避免全胃切除术.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 老年医学 老年医学
背景情况:
- 在85岁以上的患者中进行胃癌手术是有争议的,因为预期寿命短和并发症.
- 肺炎是这种老年人群中常见的死亡原因.
- 治愈性胃切除术的指示需要仔细考虑预后因素.
研究的目的:
- 为了确定治疗性胃切除术的老年胃癌患者 (≥85岁) 整体生存期的预后因素.
- 分析与肺炎相关死亡相关的因素.
- 评估不同手术治疗对生存结果的影响.
主要方法:
- 对114名85岁以上的胃癌患者 (2010-2019) 的回顾性分析.
- 考克斯比例危险模型用于76名患者的预后因子分析 (不包括cStage IVB和内镜下膜剖析).
- 分析包括整体生存率和肺炎特异性生存率.
主要成果:
- 远端胃切除术在老年胃癌患者中显示出比没有手术更好的预后.
- 生理学得分 (POSSUM),临床阶段 (cStage) 和治疗方法是整体存活期的独立预后因素.
- 总胃切除术与远端胃切除术相比,与肺炎特异性死亡风险更高有关.
结论:
- 远程胃切除术是选择老年胃癌患者 (≥85岁) 的可行选择,与非手术治疗相比,改善了存活率.
- 在这个年龄段,由于术后肺炎风险增加,应谨慎对待全胃切除术.
- 仔细选择患者和考虑手术方法对于优化非常老的胃癌患者的治疗结果至关重要.
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