Kunisaki Chikara, Shimada Hiroshi, Nomura Masato, Matsuda Goro, Otsuka Yuichi, Ono Hidetaka, Akiyama Hirotoshi
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Anticancer Res. 2004 Sep-Oct;24(5B):3169-75.
The purpose of the present study was to clarify prognostic factors and to investigate appropriate therapeutic strategies for T2 gastric carcinoma. A total of 297 consecutive patients with T2 gastric carcinoma (T2a; 130, T2b; 167) were enrolled in this study. The overall 5-year survival rate was 75.3%. There was a significant difference in survival between T2a and T2b tumor. Multivariate analysis showed that age, depth of invasion and lymph node metastasis independently influenced prognosis. Peritoneal recurrence was frequently observed in 37 patients. Multivariate analysis revealed that lymph node metastasis was an independent predictive factor for peritoneal recurrence. Furthermore, the quantity of the stroma was an independent prognostic factor for hematogenous metastasis, and lymph node metastasis for lmphatic metastasis. Prophylactic therapeutic strategy should be advised for patients with many metastatic lymph nodes, for peritoneal or lymphatic recurrence and in patients with "medullary" stroma for hematogenous recurrence.
本研究的目的是阐明T2期胃癌的预后因素并探讨合适的治疗策略。本研究共纳入了297例连续的T2期胃癌患者（T2a期130例，T2b期167例）。总体5年生存率为75.3%。T2a期和T2b期肿瘤患者的生存率存在显著差异。多因素分析显示，年龄、浸润深度和淋巴结转移独立影响预后。37例患者中经常观察到腹膜复发。多因素分析显示，淋巴结转移是腹膜复发的独立预测因素。此外，间质数量是血行转移的独立预后因素，而淋巴结转移是淋巴转移的独立预后因素。对于有多个转移淋巴结、有腹膜或淋巴复发的患者以及有“髓质”间质发生血行复发的患者，应建议采取预防性治疗策略。
