残胃复发癌30例的外科治疗及其预后分析

目的分析残胃复发癌的外科疗效和影响预后因素。方法对本院1993年1月至2007年12月间因胃癌根治术后复发再次接受外科手术的30例临床资料进行回顾性总结。用Kaplan-Meier和Cox回归模型行生存分析,Long-rank行有效性检验。结果总体平均生存期30.52个月,中位生存期25个月。其中根治性切除19例(63.3%),平均生存41.43个月,非根治性手术11例(36.7%),平均生存16.85个月(P0.01)。Kaplan-Meier分析提示病理分期、病理类型、根治情况、有无腹膜种植、是否肝转移与生存期相关(P0.01),而性别、年龄、复发距初次手术时间、化疗与否与生存期无关。结论临床分期、腹膜种植及根治性手术是影响残胃复发癌预后的主要因素,残胃复发癌的个体化治愈性切除仍可获得较好的疗效。

Surgical treatment and prognosis analysis of the remnant stomach relapse cancers

Objective To investigate the surgical treat efficiency and the prognosis impact of the remnant stomach relapse cancers. Methods The clinical data of 30 cases with relapse stomach cancer accepted twice surgical operation were summarized retrospectively from January 1993 to December 2007. The statistical survival analyses were done by KaplanMeier and Cox regress model, the validity prooftest were analyzed by Longrank. Results The total average life span were 30.52 months, the middle life span were 25 months. The life span of 19 cases（63.3%） received radical excision were 41.43 months, while 11 cases （36.7%） accepted nonradical excision could survive for 16.85 months medially （P0.01）. The life span were correlated with pathologic staging, diffusetype, radical matter, peritoneal seeding, liver metastasis （P0.01）, but the factors including sex, age, the time between tumor relapse and the first operation and chemotherapy schedule were no correlated with the survival time. Conclusions Clinical staging, peritoneal implantation or radical excision matters are major factors impacting the prognosis of the remnant stomach relapse cancers. The therapeutic effect can still get with the individual healing excision.