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Treatment for isolated loco-regional recurrence of gastric adenocarcinoma: Does surgery play a role?

查看全文 作　　者：Fabio [1]Carboni;Pasquale [1]Lepiane;Roberto [1]Santoro;Riccardo [1]Lorusso;Pietro [1]Mancini;Massimo [2]Carlini;Eugenio [1]Santoro 高影响力作者 机构地区：[1]Department of Digestive Surgery and Liver Transplantation;[2]Division of General A.T.Surgery高影响力机构 出　　处：《World Journal of Gastroenterology》索引2005年第11卷第44期,共4页高影响力期刊 摘　　要：AIM: To evaluate the role of surgical treatment for isolated loco-regional recurrences of operated gastric adenocarcinoma. METHODS: Among the 837 patients operated for gastric adenocarcinoma between December 1979 and April 2004, 713 (85%) underwent resection with curative intent. A retrospective review of a prospectively collected gastric cancer database was carried out. Overall recurrence rate was 44% (315 cases), with 75% occurring within the first 2 years from the operation. Isolated L-R recurrences were observed in 38 (12%) patients. Symptomatic lesions were observed in 27 (71%). RESULTS: Six (16%) patients were macroscopically resected with curative intent. The recurrence was located in the gastric stump after a STG in three patients, in the esophagojejunal anastomosis after a TG in two patients and in the gastric bed after a TG in one patient. Surgical procedures consisted of three secondary TG, two esophagojejunal resection and one excision of an extraluminal recurrence. Postoperative complications occurred in two patients (33%), including one anastomotic leakage and one hemorrhage. The latter patient died of sepsis 35 d after the surgery (mortality rate 17%). All patients died of recurrent gastric cancer: 2 within 1 year from surgery (8 and 11 mo, respectively), 2 after 16 and 17 mo respectively and 1 after 28 mo from the second operation. CONCLUSION: Surgery plays a very limited role in the treatment for isolated loco-regional recurrence of gastric adenocarcinoma. 关 键 词：胃癌 手术治疗 病理机制 临床表现
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