Otsuji E, Toma A, Kobayashi S, Cho H, Okamoto K, Hagiwara A, Yamagishi H
Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Am J Surg. 2000 Aug;180(2):127-32. doi: 10.1016/s0002-9610(00)00436-0.
Extended lymphadenectomy performed with gastrectomy has been reported to prolong survival of patients with early gastric cancer. However, some authors question the value of extensive lymphadenectomy in these patients, especially since much recent discussion of patient quality of life after gastrectomy has favored less invasive operations.
We retrospectively analyzed 485 patients who had undergone gastrectomy for early cancer in order to evaluate the effect of extended versus limited lymphadenectomy on postoperative survival. Various prognostic factors were examined for patients whose tumors were located in the distal third of the stomach.
Although extended radical lymphadenectomy did not prolong postoperative survival when early gastric cancer was located in the middle or proximal third of the stomach, it did when the tumor occupied the distal third.
Performance of extended radical lymphadenectomy was a significant prognostic factor for early gastric cancer patients when tumors were located in the distal third of the stomach.
据报道，胃癌根治术联合扩大淋巴结清扫术可延长早期胃癌患者的生存期。然而，一些作者对这些患者进行广泛淋巴结清扫术的价值提出质疑，尤其是近期关于胃癌切除术后患者生活质量的诸多讨论更倾向于采用侵入性较小的手术。
我们回顾性分析了485例因早期癌症接受胃切除术的患者，以评估扩大淋巴结清扫术与有限淋巴结清扫术对术后生存的影响。对肿瘤位于胃远端三分之一的患者检查了各种预后因素。
虽然早期胃癌位于胃中三分之一或近端三分之一时，扩大根治性淋巴结清扫术并未延长术后生存期，但当肿瘤位于远端三分之一时则有此效果。
当肿瘤位于胃远端三分之一时，扩大根治性淋巴结清扫术是早期胃癌患者的一个重要预后因素。
