老年胃癌的临床特点
Clinical Characteristics of Gastric Cancer in the Elderly Patients
查看参考文献8篇
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文摘
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目的探讨老年胃癌患者的临床表现,治疗及预后特点.方法将北京协和医院肿瘤内科收治的252例胃癌患者分为老年组(≥65岁)与非老年组,对比分析两组患者的临床资料.结果老年胃癌患者占36.0%.老年组男:女=3.74:1,男性患者比例明显高于非老年组(P=0.020).腹胀腹痛为最常见临床表现,但老年组发生率明显低于非老年组(43.3%比61.7%,P=0.005);老年组消瘦发生率明显高于非老年组(15.6%比6.2%)(P=0.015).老年胃癌患者合并第二肿瘤的概率明显高于非老年组(12.2%比2.5%)(P=0.002).老年组贲门胃底癌最常见,占36.7%,非老年组胃窦癌最常见,占34.6%.老年组2.2%的患者胃癌为多起源,而非老年组均为单中心起源.总体77.8%的患者接受了手术治疗,其中根治性切除率为70.9%,老年组与非老年组的比例相近.98%的患者接受了化疗,老年组接受三线及三线以上化疗的患者比例仅为非老年组的1/3(3.3%比9.3%),但差异无统计学意义.在方案选择方面,老年组的患者选择了FOLFOX/XELOX的两药联合方案(73.3%).中位生存时间老年组26.5个月,非老年组28.0个月,两组差异无统计学意义(P=0.835).按分期分层比较,Ⅳ期老年组中位生存时间(22.7个月)有较非老年组(16.1个月)延长的趋势,但差异无统计学意义(P=0.057).结论老年胃癌患者中男性比例更高,易以消瘦起病,贲门胃底癌最常见,多中心起源及合并第二肿瘤的比例较非老年组升高;治疗方面,老年胃癌患者可以耐受规范的手术及化疗,手术比例与非老年组相近,患者选择了两药而非三药的联合化疗方案;老年胃癌整体预后与非老年患者相似 |
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其他语种文摘
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Objective To investigate the clinical manifestations, treatment, and prognosis of gastric cancer in the elderly patients. Method A total of 252 patients with gastric cancer who admitted to the Oncolo-gy Department of Peking Union Medical College Hospital were divided into elderly group(≥65 years)and non-elderly group(< 65 years)and the clinical characteristics of these two groups were analyzed and com-pared. Results The elderly accounted for 36.0% of all gastric cancer patients in our department. The propor-tion of male was significantly higher in elderly group than non-elderly group(male:female = 3.74:1,P = 0.020). Abdominal satiety and pain were the most common symptoms, which were significantly lower in elder-ly group(43.3% vs.61.7%,P = 0.005). However, the frequency of weight loss was significantly higher in the elderly group(15.6% vs.6.2%,P = 0.015). Significantly more elderly patients with gastric cancer were found the second tumors(12.2% vs.2.5%,P = 0.002).The most common tumor location was cardia(36.7%)in elderly group and antrum(34.6%)in non-elderly group. A small proportion(2.2%)of elderly patients had multi-original lesions, which was not found in non-elderly group. The overall rate of surgery and R0 resection rate were 77.8% and 70.9% respectively, which were similar in both groups. The overall rate of chemotherapy was 98%.The ratio was one third compared with younger patients who received three and more than three lines chemotherapy(3.3% vs.9.3%), but did not reach statistical difference. More elderly patients chose FOLFOX/XELOX regimen(73.3%)compared with younger arm. The median survival time was 26.5 months in elderly group and 28.0 months in non-elderly group(P = 0.835). Subgroup analysis showed that the median survival time of stage Ⅳ gastric cancer was longer in elderly group than in non-elderly group(22.7 months and 16.1 months, respectively;P = 0.057), which was marginally statistically signifi-cant. Conclusions More old men may get gastric cancer. More elderly patients may present with weight loss. Cardia is the most common tumor location. The ratio of multi-original lesions and secondary tumors is higher for elderly patients. Elderly patients with good performance status can receive surgery and chemotherapy safely. The resection rate is similar between elderly and non-elderly patients. Elderly patients receive more two-drug combination regimens. The overall prognoses are similar between elderly patients and non-elderly patients |
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来源
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中国医学科学院学报
,2010,32(4):412-416 【核心库】
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DOI
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10.3881/j.issn.1000-503x.2010.04.011
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关键词
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老年
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胃癌
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手术
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化疗
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预后
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地址
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中国医学科学院北京协和医学院北京协和医院肿瘤内科, 北京, 100730
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1000-503X |
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学科
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肿瘤学 |
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文献收藏号
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CSCD:4031451
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