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The Clinical Value of Non-curative Resection Followed by Chemotherapy for Incurable Gastric Cancer.

机译:非治愈性切除术后化学疗法治疗不治性胃癌的临床价值。

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The clinical value of a non-curative resection for gastric cancer is still controversial. We analyzed the clinical outcomes of patients who underwent non-curative gastric resection.Data from a total of 178 patients who underwent non-curative resection for advanced gastric cancer at Seoul St. Mary's hospital were reviewed. Factors related to the incurability were classified as peritoneal metastasis (P), liver metastasis (H), extra-abdominal metastasis (X), direct adjacent organ invasion that was unresectable (T). The clinicopathologic data, survival, and quality of life of patients were evaluated.The overall median survival time was 12.1?months, and that for the patients with gastrectomy with chemotherapy was 14.3?months. Operation-related complications occurred in 20 patients (11.2 %). Five patients (2.8 %) died of postoperative complications within 30?days, and 43 patients (24.2 %) had symptoms and signs of gastric outlet obstruction or uncontrolled bleeding. The mean duration of postoperative hospital stay was 15.9?days for those symptomatic patients, and the symptom-relieved period was 8.6?months.There might be a role for non-curative resection followed by chemotherapy for incurable gastric cancer, in terms of survival, and this treatment approach should be carefully considered because of the high mortality rate associated with the disease. A large, randomized, prospective study is warranted to prove the benefit of non-curative resection in patients with incurable gastric cancer.
机译:胃癌非根治性切除术的临床价值仍存在争议。我们分析了接受非根治性胃切除术的患者的临床结局,并回顾了首尔圣玛丽医院共178例接受了非根治性胃癌治疗的晚期胃癌患者的数据。与不可治愈性相关的因素分为腹膜转移(P),肝转移(H),腹外转移(X),无法切除的直接相邻器官浸润(T)。评估患者的临床病理数据,生存率和生活质量。总中位生存时间为12.1?个月,而胃癌切除化疗患者的总中位生存时间为14.3?月。手术相关并发症发生在20例患者中(11.2%)。 5例患者(2.8%)在30天之内死于术后并发症,而43例患者(24.2%)出现胃出口阻塞或出血不受控制的症状和体征。这些有症状患者的平均住院时间为15.9天,症状缓解期为8.6天。从治愈率,生存率,无治愈性胃癌的治疗角度考虑,非根治性切除联合化疗可能有一定作用。由于与疾病相关的高死亡率,应该仔细考虑这种治疗方法。有必要进行一项大型,随机,前瞻性研究,以证明非治愈性切除术在顽固性胃癌患者中的益处。

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