Ⅲ、Ⅳ期胃癌新辅助化疗后再手术疗效观察

目的 探讨Ⅲ、Ⅳ期胃癌新辅助化疗后再手术的疗效.方法 选择Ⅲ、Ⅳ期胃癌患者120例,其中常规手术组52例,观察组68例,采用新辅助化疗＋手术治疗,观察指标为手术切除率、实体瘤进展评估和术后3个月、6个月和1年复发率.结果 观察组根治术62.24％ （43/68）,高于对照组46.15％（24/52）（x2=5.81,P＜0.05）;观察组姑息性切除术和探查术分别为20.59％（14/68）和16.18％（11/68）,均低于对照组（x2 =4.04、4.92,均P＜0.05）.观察组患者肿瘤缓解61.76％ （43/68）,高于对照组50.00％（26/52）（x2 =4.33,P＜0.05）;观察组患者肿瘤进展为17.65％（12/68）,低于对照组28.85％ （15/52）（x2=4.17,P＜0.05）;观察组患者术后3个月与6个月肿瘤复发率分别为10.29％（7/68）和17.65％（12/68）,均低于对照组（x2 =4.61,P＜0.05）.结论 新辅助化疗后再手术可以提高手术切除率,降低患者的复发率,延缓胃癌的转移和复发,改善患者的预后.

The effect of operation after neoadjuvant chemotherapy on gastric cancer patients with Ⅲ, Ⅳ grade

Objective To study the effect of operation after neoadjuvant chemotherapy on gastric cancer pa- tients with m, IV grade. Methods 120 gastric cancer patients with ]II, IV grade were selected. 52 cases in the con- trol group were given routine operation ,68 cases in the observation group received neoadjuvant chemotherapy plus op- eration treatment. The operation resection rate, solid tumor progress assessment and postoperative recurrence rate in three months, six months and one year were observed. Results The radical resection of the observation group was 62. 24% （43/68）, which was significantly higher than that of the control group 46.15% （24/52） （X2 = 5.81, P 〈 0.05 ）. The palliative resection and laparotomy of observation group were 20.59% （14/68） and 16.18% （11/68）, which were significantly lower than those of the control group （ X2 = 4.04,4.92, all P 〈 0.05 ）. Tumor remission of the observation group was 61.76% （43/68）, which was significantly higher than that of the control group 50% （26/52） （P 〈 0.05 ）. The tumor progress of the observation group was 17.65% （12/68） , which was significantly lower than that of the control group 28.85% （15/52） （ X2 = 4. 17, P 〈 0.05 ）. The tumor recurrence rates in 3 months and 6 months of the observation group were 10.29% （7/68） and 17.65% （ 12/68 ）, which were significantly lower than those of the control group （ X2 = 4.61, P 〈 0.05 ）. Conclusion Neoadjuvant chemotherapy before operation can im- prove the operation resection rate, reduce the relapse rate, delay the recurrence and metastasis of gastric cancer, im- prove the prognosis of the oatients.