Surgical Indications for Gastrectomy Combined with Distal or Partial Pancreatectomy in Patients with Gastric Cancer
Surgical Indications for Gastrectomy Combined with Distal or Partial Pancreatectomy in Patients with Gastric Cancer
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DOI：
10.1007/s00268-012-1681-2
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Okamura，Takeshi
中科院分区：
文献类型：
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作者：
Sakamoto，Yasuo;Sakaguchi，Yoshihisa;Okamura，Takeshi
本研究的目的是阐明胃癌患者胃切除术联合胰远端或部分切除术（GP）的手术指征。方法对1994年1月至2009年12月29例经手术侵犯胰腺、无远处脏器转移的原发性胃癌行GP R0切除术。患者的特点，手术资料和临床病理特征用于生存和预后因素的分析。结果所有患者的中位无病生存期和中位生存期（MST）分别为15和30个月。根据日本胃癌分类第14版，只有pN3状态（以7个或更多病理转移淋巴结为特征）在多因素分析中被证明是预后因素。pN3组和其他组的MST分别为12个月和51个月（p< 0.001）。结论我们认为胰腺侵犯不应被视为胃切除术的禁忌症，对于需要行胰腺切除术的胃癌患者，少量淋巴结转移（6个或更少）可能是GP的候选者。
BackgroundThe purpose of this study was to clarify the surgical indications for gastrectomy combined with distal or partial pancreatectomy (GP) in patients with gastric cancer.MethodsFrom January 1994 to December 2009, 29 patients with primary gastric cancer surgically invading the pancreas without distant organ metastasis underwent GP for R0 resection. The patients’ characteristics, surgical data, and clinicopathological features were used for the analysis of survival and prognostic factors.ResultsThe median disease-free survival and median survival time (MST) of all patients were 15 and 30 months, respectively. Only pN3 status (characterized by 7 or more pathologically metastatic lymph nodes) according to the Japanese Classification of Gastric Carcinoma, 14th edition, was shown to be a prognostic factor in a multivariate analysis. The MST of the patients with pN3 and the other patients were 12 and 51 months, respectively (p< 0.001).ConclusionsWe suggest that pancreas invasion should not be considered a contraindication for gastrectomy and that patients with a small number of lymph node metastases (six or fewer) might be candidates for GP in the case of gastric cancer that requires pancreatectomy for R0 resection.