Ojima Hitoshi, Araki Ken-Ichiro, Kato Toshihide, Okamura Kaori, Manda Ryokuhei, Hirayama Isao, Hosouchi Yasuo, Nishida Yasuji, Kuwano Hiroyuki
Department of Surgery, Gunma Prefecture Saiseikai-Maebashi Hospital, 564-1 Kami-shinden, Maebashi, Gunma 371-0821, Japan.
Anticancer Res. 2006 Mar-Apr;26(2B):1385-90.
The characteristics of stage II gastric cancer according to the Japanese Classification of Gastric Cancer (JCGC) were examined and the high-risk factors predicting poor prognosis were detected.
In total, 107 patients, who underwent clinically curative gastrectomy with D2 lymphadenectomy for stage II gastric cancer, were included. Survival curves of the depth of invasion, lymph node metastasis, the ratio of involved: resected lymph nodes and chemotherapy treatment were compared.
The survival curves were related to tumor invasion depth and lymph node metastasis. The ratio of involved resected lymph nodes was a good prognostic indicator compared to the classification of regional lymph node metastasis (N classification). Survival rates with adjuvant chemotherapy were slightly higher than without adjuvant chemotherapy, but the difference was not significant.
pT2pN1 (stage II) gastric cancers according to the JCGC, especially pSSpN1 cases, included stage IIIB and IV gastric cancers according to the International Union Against Cancer / American Joint Committee on Cancer (UICC/AJCC); therefore, the prognosis of these might be poor. With pSSpN1 cases, according to the JCGC, anticancer chemotherapy equivalent to that required for stage III gastric cancer cases is necessary.
根据日本胃癌分类（JCGC）对Ⅱ期胃癌的特征进行了研究，并检测了预测预后不良的高危因素。
总共纳入了107例行临床根治性胃切除术加D2淋巴结清扫术的Ⅱ期胃癌患者。比较了肿瘤浸润深度、淋巴结转移、受累淋巴结与切除淋巴结的比例以及化疗治疗的生存曲线。
生存曲线与肿瘤浸润深度和淋巴结转移有关。与区域淋巴结转移分类（N分类）相比，受累切除淋巴结的比例是一个良好的预后指标。辅助化疗组的生存率略高于未进行辅助化疗组，但差异不显著。
根据JCGC，pT2pN1（Ⅱ期）胃癌，尤其是pSSpN1病例，根据国际抗癌联盟/美国癌症联合委员会（UICC/AJCC）属于ⅢB期和Ⅳ期胃癌；因此，这些病例的预后可能较差。对于JCGC分类的pSSpN1病例，需要进行与Ⅲ期胃癌病例相当的抗癌化疗。
