Surgical treatment and prognosis analysis of the remnant stomach relapse cancers

doi:10.3877/cma.j.issn.1674-0793.2010.03.011

Abstract

Abstract:

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 Kaplan-Meier and Cox regress model, the validity proof-test were analyzed by Long-rank.

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 non-radical excision could survive for 16.85 months medially(P<0.01). The life span were correlated with pathologic staging, diffuse-type, radical matter, peritoneal seeding, liver metastasis (P<0.01), 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.

Key words: Gastric cancer, Remnant stomach, Relapse, Surgical treat, Prognosis

Jun ZHOU, Zhi-peng JIANG, Bin YANG, Dong-ming LAI, Yu-chao ZHANG, Ying-ru LI, Jie-bo JIN, Shuang CHEN. Surgical treatment and prognosis analysis of the remnant stomach relapse cancers[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(03): 228-231.

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https://zhptwkxwx.cma-cmc.com.cn/EN/Y2010/V04/I03/228

项目			例数	Kaplan-Meier			P值
项目			例数	均值	标准误	中位数	P值
病理分期^*			?	?	?	?	?
?	局限期(T2N1M0)		7	54.28	4.10	49	?
?	局部浸润期(T3N2M0)		14	30.43	2.21	28	0.0013
?	晚期(T4N3M1)		9	10.17	0.97	10	?
性别			?	?	?	?	?
?	?	男	23	32.65	3.36	33	0.1743
?	?	女	7	30.23	1.19	31	0.1743
?	年龄(岁)		?	?	?	?	?
?	?	≤ 58	19	32.13	2.94	31	0.9362
?	?	>59	11	30.19	2.87	30	0.9362
?	距首次手术时间(年)		?	?	?	?	?
?	?	≤ 2	18	25.11	2.87	27	0.6475
?	?	>2	12	30.25	1.09	29	0.6475
?	分化程度		?	?	?	?	?
?	?	高、中	12	42.78	2.28	38	0.0018
?	?	低、未^#	18	25.76	1.13	26	0.0018
?	根治情况		?	?	?	?	?
?	?	根治	19	41.43	2.73	39	0.0012
?	?	非根治	11	16.85	1.62	13	0.0012
?	腹膜种植		?	?	?	?	?
?	?	无	27	42.72	2.85	38	0.0013
?	?	有	3	11.03	1.69	12	0.0013
?	肝转移		?	?	?	?	?
?	?	无	27	38.72	2.72	36	0.0012
?	?	有	3	13.35	1.86	15	0.0012
?	盆底种植		?	?	?	?	?
?	?	无	28	42.63	2.74	37	0.0012
?	?	有	2	10.98	1.58	11	0.0012
?	肺转移		?	?	?	?	?
?	?	无	29	43.59	2.54	39	0.0011
?	?	有	1	10.06	1.58	11	0.0011
?	辅助化疗		?	?	?	?	?
?	?	有	24	33.28	3.82	31	0.5367
?	?	无	6	29.78	2.03	28	0.5367

项目			例数	Kaplan-Meier			P值
项目			例数	均值	标准误	中位数	P值
病理分期^*			?	?	?	?	?
?	局限期(T2N1M0)		7	54.28	4.10	49	?
?	局部浸润期(T3N2M0)		14	30.43	2.21	28	0.0013
?	晚期(T4N3M1)		9	10.17	0.97	10	?
性别			?	?	?	?	?
?	?	男	23	32.65	3.36	33	0.1743
?	?	女	7	30.23	1.19	31	0.1743
?	年龄(岁)		?	?	?	?	?
?	?	≤ 58	19	32.13	2.94	31	0.9362
?	?	>59	11	30.19	2.87	30	0.9362
?	距首次手术时间(年)		?	?	?	?	?
?	?	≤ 2	18	25.11	2.87	27	0.6475
?	?	>2	12	30.25	1.09	29	0.6475
?	分化程度		?	?	?	?	?
?	?	高、中	12	42.78	2.28	38	0.0018
?	?	低、未^#	18	25.76	1.13	26	0.0018
?	根治情况		?	?	?	?	?
?	?	根治	19	41.43	2.73	39	0.0012
?	?	非根治	11	16.85	1.62	13	0.0012
?	腹膜种植		?	?	?	?	?
?	?	无	27	42.72	2.85	38	0.0013
?	?	有	3	11.03	1.69	12	0.0013
?	肝转移		?	?	?	?	?
?	?	无	27	38.72	2.72	36	0.0012
?	?	有	3	13.35	1.86	15	0.0012
?	盆底种植		?	?	?	?	?
?	?	无	28	42.63	2.74	37	0.0012
?	?	有	2	10.98	1.58	11	0.0012
?	肺转移		?	?	?	?	?
?	?	无	29	43.59	2.54	39	0.0011
?	?	有	1	10.06	1.58	11	0.0011
?	辅助化疗		?	?	?	?	?
?	?	有	24	33.28	3.82	31	0.5367
?	?	无	6	29.78	2.03	28	0.5367

1	Otsuji E, Kobayashi S, Okamoto K, et al. Is timing of death from tumor recurrence predicable after curative resection for gastric cancer. World J Surg, 2001, 25(11):1373-1376.
2	Roderich ES, Kathryn ZN. Recurrence pattern after radical gastrectomy for gastric cancer: Prognostic factors and implications for postoperative adjuvant therapy. Ann Surg Oncol, 2002, 9(4):394-400.
3	陈峻青.胃癌根治术后复发形式和方法的选择.中国实用外科杂志, 1995, 15(12):709.
4	Kunisaki C, Shimada H, Nomura M, et al. Lymph node dissection in surgical treatment for remnant stomach cancer. Hepato gastroenterology, 2002, 49(44):580-584.
5	Hye SA, Jong WK, Moon-Won Y, et al. Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy. Ann Surg Oncol, 2008, 15(6):1632.

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