分析不同部位的胃癌肿瘤术式选择与预后

目的：分析不同部位的胃癌肿瘤术式选择与预后。方法采用回顾性方法分析，选取自2008年10月至2012年10月以来收治的100例行手术治疗的胃癌患者的临床资料，根据患者实际病症选择相宜手术，其手术方式分别为全胃切除术、联合脏器切除术、姑息切除术。分析手术结果及术后恢复情况。采用SPSS20．0软件分析统计学差异，P＜0．05表示差异有统计学意义。结果本组100例患者自2008年随访至今，47例死亡，8例失访，随访率92．0％。5年总生存率48．9％。上1/3部位、中1/3部位和下1/3部位胃癌患者的中位生存时间分别为30个月、36个月和39个月（χ2＝1．853， P＝0．396），差异无统计学意义。上1/3、中1/3、下1/3部位胃癌患者的术后并发症发生率分别为16．0％、7．0％、9．4％，上1/3部位胃癌患者的术后并发症发生率明显比中1/3、下1/3部位胃癌患者高，差异具有统计学意义（χ2＝14．692， P＝0．031）。全胃切除术患者的中位生存时间（42．12个月）和联合脏器切除术组（30．80个月）明显高于姑息术组（11．21个月），差异具有统计学意义（χ2＝8．223， P＝0．016）。全胃切除术组与联合脏器切除术组比较差异不具有统计学意义（χ2＝0．008， P＝0．927）。结论手术的选择还应根据患者实际病症选择适宜的手术方式，全胃切除术其生存时间较长，病死率较低，并发症发生率低。

Surgical options and prognosis of gastric cancer in different parts

Objective To analyze the prognosis and surgical options of gastric cancer in different parts.Methods From October 2008 to October 2012, clinical data of 100 patients with gastric cancerwho had been treated at our hospital were analyzed retrospectively according to individual conditions of patients with proper selection of operative procedures , including total gastrectomy , combined organs resection , palliative resection.Analysis using SPSS20.0 for Windows software was performed in terms of clinical outcome and postoperative recovery.A P value 〈0.05 was considered significantly different .Results The 100 patients were followed up but 47 patients died, 8 patients were lost to follow-up, with a follow-up rate of 92.0%and a 5 year survival rate of 48.9%.The median survival times on up 1/3 site, medial 1/3 site and low 1/3 site in patients with gastric cancer were 30 months, 36 months and 39 months respectively （χ2 =1.853, P=0.396）. The complication incidence was higher in up 1/3 site of gastric cancer when compared with other sites （χ2 =14.692, P=0.031）.The median survival time of patients who underwent total gastrectomy （42.12 months） and combined organ resection group （30.80 months） was significantly higher than that of palliative resection group （11.21 months） （χ2 =8.223, P=0.016）.However, total gastrectomy group and combined organ resection group were not significantly different （χ2 =0.008, P=0.927）.Conclusions Individual operative procedure should be performed according to the actual conditions.Total gastrectomy has advantages of longer survival time , lower mortality rate and lower rate of complications .