Isozaki H, Fujii K, Nomura E, Mabuchi H, Nishiguchi K, Hara H, Tanigawa N
First Department of Surgery, Okayama University Medical School, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2669-72.
BACKGROUND/AIMS: The purpose of this study was to investigate the prognostic factors of advanced gastric carcinoma without serosal invasion (pT2 gastric carcinoma), for the planning of therapeutic strategy.
Prognostic factors were evaluated by univariate and multivariate analysis in a total of 304 curatively resected pT2 gastric carcinoma patients in whom the tumor invaded the muscularis propria or the subserosa.
Macroscopic type, depth of invasion, lymph node metastasis and venous invasion were significantly related to outcome, using univariate analysis. Lesions resembling early gastric carcinoma had better prognosis than lesions belonging to one of the Borrmann types. Multivariate analysis (Cox's proportional hazards model) demonstrated that macroscopic type, lymph node metastasis and venous invasion, but not depth of invasion, were significant prognostic factors.
Macroscopic appearance, lymph node metastasis and venous invasion were the important prognostic factors of pT2 gastric carcinoma. Extensive lymph node dissection and aggressive post-operative chemotherapy should be performed, especially in Borrmann type lesions with lymph node metastasis.
背景/目的:本研究旨在探讨无浆膜侵犯的进展期胃癌(pT2 胃癌)的预后因素,以制定治疗策略。
对 304 例肿瘤侵犯固有肌层或浆膜下层且接受根治性切除的 pT2 胃癌患者,通过单因素和多因素分析评估预后因素。
单因素分析显示,大体类型、浸润深度、淋巴结转移和脉管侵犯与预后显著相关。类似早期胃癌的病变预后优于 Borrmann 分型中的任何一种病变。多因素分析(Cox 比例风险模型)表明,大体类型、淋巴结转移和脉管侵犯而非浸润深度是显著的预后因素。
大体形态、淋巴结转移和脉管侵犯是 pT2 胃癌的重要预后因素。应进行广泛的淋巴结清扫和积极的术后化疗,尤其是对于伴有淋巴结转移的 Borrmann 型病变。