张成武， Email: email@example.com
Objective: To investigate the clinicopathologic features and prognosis of patients with gastric stump cancer (GSC) in Qinghai area.
Methods: The clinical data of 102 patients with GSC admitted in the Department of Gastrointestinal Surgery of Affiliated Hospital of Qinghai University and Department of Oncology of Qinghai Provincial People’s Hospital from January 2012 to October 2018 were retrospectively analyzed.
Results: Of the patients, the initial disease was benign in 20 cases (19.6%) and was malignant in 82 cases (80.4%). The time interval between the initial operation and the development of GSC in patients with initial benign disease was 204 (108 to 481) months, and in those with malignant disease was 38 (5 to 204) months, the GSC occurred later than 60 months after the initial operation in all cases in the former and occurred within 60 months after the initial operation in most cases (84.2%) in the latter, and differences also existed between the two groups of patients in the constituent ratios of the initial operation types and digestive tract reconstruction methods (all P<0.05). The GSC mainly occurred beyond the anastomotic stoma (60.0%) in patients with initial benign disease and mainly occurred at the anastomotic stoma (68.3%) in those with malignant disease, and the difference had statistical significance (P<0.05). Among the 102 patients, 11 cases (10.8%) underwent radical surgery, 19 cases (18.6%) underwent palliative surgery and 72 cases (70.6%) not undergo surgery. Follow-up was performed in
83 patients for 1 month to 50 months. The 3-year overall survival rate in the whole group of patients was 25.5%, and the survival rate of the patients showed no significant association with the benign or malignant nature of the initial diseases (P=0.086), but was significantly related to the histopathological type of GSC and presence or absence of concomitant disease as well as the levels of CEA and CA19-9 (all P<0.05).
Conclusion: The development of GSC is related to the initial operation type and digestive tract reconstruction method. The time interval and site of occurrence of GSC are different between patients with different natures of the initial diseases. The prognosis of GSC is poor, and the histopathological type of GSC, the concomitant diseases and the levels of some tumor markers have significant impacts on the prognosis of the patients.
王刚, 郑良璐, 李刚刚, 于鹏杰, 曹洪涛, 储怀祝, 张成武.青海地区残胃癌患者的临床特征与预后分析[J].中国普通外科杂志,2019,28(10):1212-1220.复制