CAJ | 학술논문

目的探讨75岁及以上老年胃癌患者是否应接受手术治疗以及手术应采用何种术式.方法回顾性分析2005年1月至2009年12月间,76例活动状态评分小于4分且可行根治性手术的胃癌患者.将其分为手术治疗组和支持治疗组；手术组又分为D0(未行胃周淋巴结清扫)+D1(清扫胃周淋巴结,总数大于15枚)手术组和D2(清扫伴随腹腔血管周围淋巴结,总数大于15枚)手术组,对各组临床资料、治疗和生存情况进行分析. 结果手术治疗组5年生存率36.4％,而支持治疗组3年生存率为0％；D0+D1手术组和D2手术组的并发症发生率差异无统计学意义；淋巴廓清数D2手术组为(27.4±12.8)个,在D0+D1手术组为(14.6±12.1)个(t=-4.095,P=0.000)；5年生存率D2手术组(47.3％)高于D0+ D1手术组(18.5％)(P=0.010). 结论老年胃癌患者可以从根治手术中获益,标准D2根治手术在75岁及以上的老年患者依然是适宜的手术方式.
목적 탐토75세급이상노년위암환자시부응접수수술치료이급수술응채용하충술식.방법 회고성분석2005년1월지2009년12월간,76례활동상태평분소우4분차가행근치성수술적위암환자.장기분위수술치료조화지지치료조；수술조우분위D0(미행위주림파결청소)+D1(청소위주림파결,총수대우15매)수술조화D2(청소반수복강혈관주위림파결,총수대우15매)수술조,대각조림상자료、치료화생존정황진행분석. 결과 수술치료조5년생존솔36.4％,이지지치료조3년생존솔위0％；D0+D1수술조화D2수술조적병발증발생솔차이무통계학의의；림파곽청수D2수술조위(27.4±12.8)개,재D0+D1수술조위(14.6±12.1)개(t=-4.095,P=0.000)；5년생존솔D2수술조(47.3％)고우D0+ D1수술조(18.5％)(P=0.010). 결론 노년위암환자가이종근치수술중획익,표준D2근치수술재75세급이상적노년환자의연시괄의적수술방식.
Objective To investigate whether gastric resection is feasible for the patients aged 75 years and over and which surgery type should be taken in elderly patients.Methods 76 gastric cancer patients undergoing radical surgery with performance status score less than 4 were reviewed retrospectively from 2005 to 2009.63 cases underwent curative resection,in which 32 cases had D0 or D1 lymph node dissection and 31 cases had D2 lymph node dissection,and 13 cases received best supportive care.The dissected lymph nodes,morbidity,mortality and long-term survival rate in the two groups were analyzed.Results 5-year survival rate was 36.4％ in curative resection group,and 3-year survival rate was 0％ in supportive group.There was no significant difference in surgery complications between the D0+ D1 group and the D2 group.The number of dissected lymph nodes was more in D2 group than in D0+D1 group [(27.4± 12.8) vs.(14.6± 12.1),t=-4.095,P＜ 0.001].5-year survival rate was higher in D2 group than in D0+D1 group(47.3％ vs.18.5％,P＜ 0.05).Conclusions Curative resection of gastric cancer and standardized D2 lymph node dissection is suitable and beneficial for the elderly patient.