【摘要】 目的探讨新辅助化疗对进展期胃癌手术安全性的影响及近期疗效分析。方法收集2012年3月至2016年3月广西医科大学附属肿瘤医院收治的Ⅲ期胃癌患者138例,行新辅助化疗50例(观察组),直接手术治疗88例(对照组),比较分析两组手术并发症的发生情况及近期疗效。结果观察组和对照组术中输血、中转开腹、术中出血量、手术时间及淋巴结转移差异具有统计学意义(P<0.05),联合脏器切除率差异无统计学意义(P>0.05),术后主要并发症发生率比较差异亦无统计学意义(30.0%vs 17.0%,P>0.05);单因素分析显示手术时间、出血量、新辅助化疗、术前化疗方案及周期等与术后并发症发生无关(P>0.05)。观察组中位生存时间为36.9个月,对照组为30.9个月,两组生存曲线比较差异无统计学意义(P=0.317);手术根治率差异有统计学意义(84.0%vs 68.2%,P=0.042),术后12个月复发率差异亦有统计学意义(34.0%vs52.3%,P=0.038)。结论新辅助化疗不是影响胃癌术后并发症发生的因素,同时可提高进展期胃癌的根治性切除率,降低术后近期复发率,是一种安全有效的治疗手段。更多还原

【Abstract】 Objective To explore the safety of neoadjuvant chemotherapy for advanced(stage Ⅲ)gastric cancer and its recent efficacy. Methods A total of 138 patients with locally advanced gastric cancer(stage Ⅲ) confirmed by Affiliated Tumor Hospital of Guangxi Medical University from March 2012 to March 2016 were divided into trial group(n=50) and control group(n=88). Patients in the trial group underwent both neoadjuvant chemotherapy and surgery,control patients underwent surgery and adjuvant chemotherapy.Surgical complications and recent efficacy were compared between the two groups. Results The median survival time was 36.9 months in trial group and 30.9 months in control group(P =0.317). The trial group showed lower recurrence rates of 12 months(34.0% vs52.3%,P=0.038),and higher R0 resection rate(84.0% vs 68.2%,P=0.042). The two groups experienced similar major complications(P>0.05). The trial group showed more intraoperative blood transfusion,more intraoperative blood loss,longer operation time and more lymph node metastasis(P <0.05),and there was no difference between patients who underwent combined organ resection(P>0.05). Conclusion Neoadjuvant chemotherapy can improve the R0 resection rate,reduce recurrence rate of advanced gastric cancer,and is not a risk factor for surgical complications.更多还原