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Gastric Cancer:单纯手术足以治疗具有广泛淋巴结转移的T1胃癌

2020-04-14 MedSci原创 MedSci原创

单独手术是否足以治疗T1N2M0(IIA期),T1N3a / bM0(IIB / IIIB期)和T3N0M0(IIA期)胃癌的患者仍不清楚。本项研究旨在探究这一可能性。

背景:单独手术是否足以治疗T1N2M0(IIA期),T1N3a / bM0(IIB / IIIB期)和T3N0M0(IIA期)胃癌的患者仍不清楚。本项研究旨在探究这一可能性。

方法:研究人员回顾性分析了2000年1月至2012年12月在日本国立癌症中心医院诊断为pT1N2-3b / pT3N0胃癌并接受R0胃切除和淋巴结清扫术的236例患者的临床记录。并进行了相关统计分析。

结果:病理为T1N2-3b和T3N0癌症患者的5年无复发生存率(RFS)(95%置信区间[CI])分别为73.9%(63.1-84.7)和89.5%(84.0-95.0))。经多因素Cox回归分析确定的pT1N2-3癌症患者生存的唯一重要预后因素是pN分期(N3a/N2:危险比[HR] 2.940,95%CI 1.314–5.577; N3b/N2:HR 8.688、95%CI 3.096–24.382)和肿瘤直径(<30/≥30 mm)(HR 2.919; 95%CI 1.351–6.304)。使用这两个重要的预后因素将pT1N2-3胃癌患者分为3个风险类别(高,中,低),发现3个风险组之间的5年RFS发生率显着不同(低风险,93.0% ;中度风险为66.7%;高风险为25.0%;P <0.001)。

结论:直径≥30 mm的pT3N0和大的pT1N2的预后良好,而至少N3a / b或肿瘤直径<30 mm的pT1N2-3的预后相对较差。

原始出处:

Masahiro Yura. Et al. Is surgery alone sufficient for treating T1 gastric cancer with extensive lymph node metastases? Gastric Cancer.2020.

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    2020-10-26 skhzy
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    2020-07-23 许安
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