CAJ | 학술논문

目的探讨胃肠间质瘤(GIST)外科治疗效果及其影响因素.方法对中山大学肿瘤防治中心1990年1月至2010年2月间收治的首次进行外科治疗且能够完全切除的277例GIST患者临床资料进行回顾性分析,对其病理切片重新复核并加以随访.结果 277例患者中男性176例,女性101例,年龄20～81(中位年龄57)岁；肿瘤位于结直肠28例,小肠76例,胃173例.均予以肿瘤完整切除,其中局部切除98例,肿瘤及所在器官切除64例,扩大切除术115例:3种切除方式患者术后5年生存率分别为83.5％、71.9％和61.9％,差异无统计学意义(P＞0.05).Cox模型分析显示,肿瘤大小和复发转移是影响GIST患者预后的独立因素(P＜0.05).结论胃肠道GIST仍以外科治疗为主,原则上施行肿瘤完全切除即可,广泛切除或扩大淋巴结清扫并不能提高生存率.
목적 탐토위장간질류(GIST)외과치료효과급기영향인소.방법 대중산대학종류방치중심1990년1월지2010년2월간수치적수차진행외과치료차능구완전절제적277례GIST환자림상자료진행회고성분석,대기병리절편중신복핵병가이수방.결과 277례환자중남성176례,녀성101례,년령20～81(중위년령57)세；종류위우결직장28례,소장76례,위173례.균여이종류완정절제,기중국부절제98례,종류급소재기관절제64례,확대절제술115례:3충절제방식환자술후5년생존솔분별위83.5％、71.9％화61.9％,차이무통계학의의(P＞0.05).Cox모형분석현시,종류대소화복발전이시영향GIST환자예후적독립인소(P＜0.05).결론 위장도GIST잉이외과치료위주,원칙상시행종류완전절제즉가,엄범절제혹확대림파결청소병불능제고생존솔.
Objective To investigate the outcome of surgical treatment for gastrointestinal stromal tumor (GIST) and the associated factors.Methods A total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University.The clinical data were retrospectively reviewed and the pathological examination was reviewed.Follow-up was performed.Results There were 176 males and 101 females.The age ranged from 20 to 81 years old (median,57).Location of the tumor included colorectum (n=28),small bowel(n=76),stomach(n=173).All the patients had en bloc resection,including local excision in 98 patients,organ resection in 64,and extended resection in 115.The 5-year survival rates were 83.5％,71.9％,and 61.9％ in the three different procedures,respectively,and the difference was not statistically significant (P＞0.05).Cox model showed that the tumor size,recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients (P＜0.05).Conclusions Surgery remains the major approach for gastrointestinal GIST.Complete resection is the principal treatment.Extensive resection or extended lymph nodes dissection is not associated with improved survival.