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目的探讨胃癌累及胰腺的外科治疗方法与预后的关系。方法回顾性分析我院1984年6月～2003年10月手术治疗累及胰腺的胃癌120例。结果本组120例中,根治切除组41例,姑息切除组23例,未切除组56例。根治组41例中经病理证实胰腺有癌细胞浸润者30例,占73.2%,淋巴结转移率为85.4%。其中No10、11淋巴结转移率为73.1%。术后102例得到随访,随访率为85%,1、3、5年的生存率分别为:根治切除组为73%、37%、17%,姑息切除组为22%、9%、4%,未切除组为9%、2%、0%。根治切除组1,3年生存率明显高于姑息性切除组和未切除组(P<0.05),5年生存率明显高于未切除组(P<0.01),但与姑息性切除组无显著性差异。姑息性切除组和未切除组1、3年生存率无显著性差异,但5年生存率明显高于未切除组(P<0.01)。结论胃癌累及胰腺的根治切除可提高1,3年生存率,选择合适的适应征是关键。姑息切除有助于改善生存质量,对改善预后意义不大。
Objective To investigate the relationship between surgical treatment and prognosis of gastric cancer involving the pancreas. Methods A retrospective analysis of our hospital from June 1984 to October 2003 surgical treatment of 120 cases of gastric cancer involving the pancreas. Results In this group of 120 cases, radical resection group 41 cases, palliative resection group 23 cases, 56 cases without resection group. In the radical group, 30 cases (73.2%) had lymph node metastasis, and the rate of lymph node metastasis was 85.4%. No10, 11 lymph node metastasis rate was 73.1%. The postoperative 102 patients were followed up with a follow-up rate of 85%. The survival rates at 1, 3 and 5 years were 73%, 37% and 17% in the radical resection group and 22%, 9% and 4% in the palliative resection group , 9%, 2%, 0% in the group without resection. The 1-year and 3-year survival rates were significantly higher in the radical resection group than those in the palliative resection group and the non-resected group (P <0.05). The 5-year survival rate was significantly higher in the radical resection group than in the non-resected group (P <0.01) Sex differences. The 1-year and 3-year survival rates of palliative resection group and non-resection group were not significantly different, but the 5-year survival rate was significantly higher than that of the group without resection (P <0.01). Conclusions Radical resection of the pancreas involving gastric cancer can increase the one and three-year survival rate. It is the key to choose appropriate indications. Palliative resection helps to improve the quality of life, little to improve the prognosis.