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文献詳細

雑誌文献

臨床外科62巻11号

2007年10月発行

特集 癌診療に役立つ最新データ2007-2008

Ⅵ.胃癌

胃癌の再発診療に関する最新のデータ

著者: 荒井邦佳1 井上暁1 大村健史1 梅北信孝1 北村正次1

所属機関: 1東京都立墨東病院外科

ページ範囲:P.199 - P.206

文献概要

 要旨:胃癌再発は術後2年以内が多く,再発形式は腹膜,肝,局所の順である.欧米と日本とではフォローアップにおいて相違があり,わが国ではルーチン検査の意義を認めているが,欧米では意義はないとの報告がみられている.再発に対する外科治療の多くはquality of life(QOL)改善などを目的とした姑息手術であり,現時点では外科的治療だけで根治が望める症例はきわめて稀と考えるべきである.根治的切除が可能で,かつ全身状態が良好な症例においてのみ外科的完全切除を治療の選択肢の1つと考えてよいが,多くの場合,再発治療の中心は化学療法に移っている.一方,新規薬剤を用いたregimenのphaseⅡ studyによって安全性と有用性が数多く検討されている.これまでのところ19%~74%の奏効率と8~15か月までのMSTを示しているものの,いまだ標準的な化学療法を呈示できていない.生存期間の延長においてはsecond line化学療法の意義が重要視されつつある.

参考文献

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