Peritoneal metastasis in relation to outcome and therapeutic strategy in gastric cancer
Peritoneal metastasis in relation to outcome and therapeutic strategy in gastric cancer
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腹膜转移与胃癌预后和治疗策略的关系
DOI：
10.21037/tcr.2017.01.13
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发表时间：
2017-02-01
影响因子：
0.9
通讯作者：
Liu, Baorui
中科院分区：
文献类型：
--
作者：
Wei, Jia;Yang, Yang;Liu, Baorui
背景：局部进展期和转移性胃癌的预后仍然很差。本研究旨在探讨进展期胃癌复发或转移的规律及影响生存的因素，为制定有效的治疗策略提供依据。方法：对349例III/IV期胃癌患者进行回顾性分析。结果：腹膜转移219例(62.8%)，远处转移208例(59.6%)。81.1%的患者在复发或确诊时发生了腹膜或肝脏转移。局部区域复发(LR)的III期患者总体生存时间长于腹膜或远处复发(DR)患者(21个月比15个月，HR：0.628；P=0.047)，而腹膜转移的IV期患者生存期短(7.5月比14个月)，死亡风险高(HR：2.026；P=0.004)。结论：腹膜转移是胃癌患者最常见的转移方式，且与预后不良有关。有效的区域治疗对指导进展期胃癌患者的进一步治疗具有重要意义。
Background: The prognosis of locally advanced and metastatic gastric cancer remains dismal. The aim of this study was to investigate the patterns of recurrence or metastasis of advanced gastric cancer and determine the factors associated with survival, which may help in identifying effective treatment strategies.Methods: A retrospective analysis of 349 patients with stage III/IV gastric cancer was performed. The relationships between metastasis patterns and clinicopathological characteristics and overall survival were evaluated.Results: Peritoneal metastasis was detected as any part of the metastasis/recurrence pattern in 219 patients (62.8%), while distant sites were involved in 208 patients (59.6%). 81.1% of the patients developed metastasis in peritoneal cavity (peritoneal or liver) at the time of recurrence or diagnosis. Stage III patients with locoregional recurrence (LR) had longer overall survival time than those with peritoneal or distant recurrence (DR) (21 vs. 15 months, HR: 0.628; P= 0.047), while stage IV patients with peritoneal metastasis had shorter survival (7.5 vs. 14 months) and a higher risk of death (HR: 2.026; P= 0.004).Conclusions: Peritoneal metastasis appears to be the most common pattern and is associated with poor prognosis in gastric cancer patients. Effective regional treatment is important to guide appropriate further therapy in advanced gastric cancer patients.