Llanos O, Guzman S, Pimentel F, Ibañez L, Duarte I
Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Dig Surg. 1999;16(5):385-8. doi: 10.1159/000018752.
BACKGROUND/AIM: The extent of gastric resection and the role of lymphadenectomy in the treatment of gastric cancer are controversial.
This study evaluates the results of radical gastric resection (D2 lymphadenectomy) in 375 patients with a gastric carcinoma operated according to a prospective protocol.
Total gastrectomy was performed in 196 and a subtotal gastrectomy in 179 patients, with an operative mortality of 3.5 and 2.8%. The presence of lymph node metastasis was related to the depth of the tumor in the gastric wall. The cumulative 5-year survival was dependent on the depth of tumoral invasion in the gastric wall and also on the presence of lymphatic metastasis. Curative resection had a significantly better 5-year survival (72%) than noncurative resection (26%).
Although it is difficult to prove the benefits of extended lymphadenectomy in the surgical treatment of gastric carcinoma, the results of these series seem to support its usefulness.
背景/目的：胃癌治疗中胃切除范围及淋巴结清扫的作用存在争议。
本研究评估了375例按照前瞻性方案接受手术的胃癌患者行根治性胃切除（D2淋巴结清扫）的结果。
196例行全胃切除术，179例行次全胃切除术，手术死亡率分别为3.5%和2.8%。淋巴结转移情况与肿瘤在胃壁的深度相关。累积5年生存率取决于肿瘤侵犯胃壁的深度以及是否存在淋巴转移。根治性切除的5年生存率（72%）显著高于非根治性切除（26%）。
尽管难以证明扩大淋巴结清扫在胃癌外科治疗中的益处，但这些系列研究结果似乎支持其有效性。
