在不可切除的胃癌中治疗途径和结果:回顾性队列分析
Yonatan Lessing1,2, Tal Inbar-Weissman1,2, Ron Cohen1,2
1Division of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, ISR.
Cureus
|December 22, 2025
概括
晚期胃癌 (AGC) 的外科手术策略有所不同,其中细胞减退手术与高温腹腔内化疗 (CRS-HIPEC) 在选定的患者中提供了最长的生存期. 息手术提供了适度的好处,而诊断手术的生存率最低.
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:
- 晚期胃癌 (AGC) 管理涉及多种不同的手术方法.
- 策略范围从诊断性手术 (DS) 到息性手术 (PP) 和带有高热性腹腔内化疗 (CRS-HIPEC) 的细胞减少手术.
- 关于这些策略对患者结果的影响的现实数据至关重要.
研究的目的:
- 描述AGC目前的手术管理策略.
- 评估不同外科手术方法对患者结果的影响.
- 为了比较DS,PP和CRS-HIPEC在AGC中的有效性.
主要方法:
- 158名AGC患者 (2014-2024) 的回顾性分析.
- 分类为诊断外科手术 (DS,n=94),息手术 (PP,n=52) 和CRS-HIPEC (n=12) 组.
- 使用统计分析 (ANOVA,奇方位,卡普兰-梅尔) 进行人口统计数据,术后结果和生存率的比较.
主要成果:
- 与PP (40.4%) 和DS (7.4%) 相比,CRS-HIPEC患者年轻 (平均49.4岁),但并发症率较高 (75.0%).
- 对于CRS-HIPEC (40.3个月) 与PP (11.5个月) 和DS (7.1个月) 相比,中位数的整体存活时间明显更长.
- 在CRS-HIPEC队列中,无病生存期为16.6个月.
结论:
- 对不可切割的AGC的手术策略是异质的,需要个性化.
- 息疗法在精选患者中提供症状缓解和适度的存活率.
- 在高度精选的队列中,CRS-HIPEC显示出延长生存的希望,需要进一步调查.
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