Clinical efficacy of laparoscopic surgery for stage Ⅳ gastric cancer after transformation therapy
10.3760/cma.j.cn431274-20220303-00151
- VernacularTitle:Ⅳ期胃癌转化治疗后腹腔镜手术治疗的临床效果
- Author:
Yongkang SHI
1
;
Huafeng QIU
;
Jun MA
;
Zaiyuan YE
Author Information
1. 浙江省人民医院（杭州医学院附属人民医院）普通外科胃肠胰外科，浙江省胃肠病学重点实验室，杭州 310014
- Keywords:
Stomach neoplasms;
Transformation therapy;
Laparoscopy
- From:
Journal of Chinese Physician
2022;24(3):330-333
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effect of laparoscopic surgery after transformation therapy for patients with stage Ⅳ gastric cancer.Methods:Clinical data of 55 patients with stage Ⅳ gastric cancer underwent transformation therapy at Zhejiang Provincial People′s Hospital from January 2018 to January 2021 were reviewed retrospectively. All patients had distant metastasis and underwent multi-disciplinary treatment (MDT) directed transformation therapy. 21 patients was appraised to have indications of laparoscopic exploration. Of which 18 patients underwent D2 radical laparoscopic gastrectomy, 1 patient underwent gastrojejunostomy and 2 patient underwent laparoscopic biopsy. The remission of patients after conversion therapy and the related intraoperative and postoperative indicators were analyzed.Results:After the transformation therapy, there were 2 cases of complete response (CR), 22 cases of partial response (PR), 14 cases of stable disease (SD) and 17 cases of progressive disease (PD). The objective response rate was 69.09%(38/55). 18 cases finally completed laparoscopic gastric cancer surgery (1 case converted to laparotomy), including total gastrectomy in 10 cases, distal gastrectomy in 8 cases, and R0 resection in 12 cases (R0 resection rate 12/18). In all 18 cases, the surgical time was (223±28)min, the intraoperative blood loss was (100±48)ml, and the number of lymph nodes resected was (28±8). The median postoperative hospital stay was 12(10.25, 19.25)d. After surgery, there were 2 cases of grade Ⅲ complications, 5 cases of grade Ⅱ complications and 1 case of grade Ⅰ complications. There was no perioperative death. The 1-year survival rate was 12/18. The median progression-free survival time was 11 months and the median overall survival time was 19 months.Conclusions:Laparoscopic surgery for stage Ⅳ gastric cancer after transformation therapy is safe and clinical effect is fine.
