系统性扩大淋巴结清扫术的价值——日本的结果。[系统性扩大淋巴结清扫术的价值——日本的结果]

Wert der systematischen erweiterten Lymphknotendissektion--Ergebnisse in Japan. [Value of systematic extended lymph node dissection--results in Japan].

作者信息

Maruyama K, Sasako M, Kinoshita T

机构信息

Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Langenbecks Arch Chir Suppl Kongressbd. 1992:130-5.

PMID:1493262

Abstract

In the National Cancer Center, 6112 patients with primary gastric cancer have undergone gastric resection since 1962, and the 5-year survival rate (5YSR) was 57.5%. In the 25-year period, 5YSR rose from 57% to 83% in stage II disease, and from 33% to 50% in stage III disease. Systematic lymph node dissection (R2 dissection) played major role in this improvement. It gave significantly better prognosis (5YSR, 48%) than incomplete dissection (31%), particularly reducing local recurrence. The proportion of local recurrence was 38% in 1967-1971, however it decreased to 16% in 1982-1986 by introduction of this treatment. Disadvantages of the dissection were minimal. Surgical death rate was 3.0% in the 1960s but it was only 0.6% in the 1980s.

摘要

自1962年以来，国立癌症中心有6112例原发性胃癌患者接受了胃切除术，5年生存率（5YSR）为57.5%。在这25年期间，II期疾病的5年生存率从57%升至83%，III期疾病的5年生存率从33%升至50%。系统性淋巴结清扫术（R2清扫）在这一改善过程中发挥了主要作用。与不完全清扫（5年生存率31%）相比，其预后明显更好（5年生存率48%），尤其降低了局部复发率。1967 - 1971年局部复发率为38%，然而通过引入这种治疗方法，1982 - 1986年该比例降至16%。这种清扫术的缺点微乎其微。20世纪60年代手术死亡率为3.0%，但在20世纪80年代仅为0.6%。