Vasilescu C, Herlea V, Tidor S, Ivanov B, Stănciulea Oana, Mănuc M, Gheorghe C, Ionescu M, Diculescu M, Popescu I
Centrul de Chirurgie Generală şi Transplant Hepatic, Institutul Clinic Fundeni.
Chirurgia (Bucur). 2006 Jul-Aug;101(4):375-84.
The main objective of the study was to evaluate the postoperative mortality and 5 year survival in gastric cancer patients undergoing a minimum of D2 lymphadenectomy.
A retrospective study was conducted on 1170 patients operated for gastric adenocarcinoma in the Department of General Surgery and Liver Transplantation of Fundeni Clinical Institute, between 1997 and April 2005. Only 443 patients underwent a curative resection, from which 216 patients had D1 resection and in 227 cases a D2 or D3/D4 lymphadenectomy was performed. Information about survival was available for 189 patients of those who had a D1 resection and for 210 of those who underwent a D2 or D3/D4 lymphadenectomy.
Postoperative mortality was 6.5% in the group of curative resection, with 9.2% for D1 and 3.9% for D2/D3 D4. Five year survival according to Kaplan Meier curves was 32 % in the D1 group vs. 51,8% in D2/D3-D4 (p <0.0001). Significant differences were noted in the median survival-- D2/D3-D4 group 63 months vs. 28 months in D1 group.
Our data support the gastric resection with a minimum of D2 lymphadenectomy in the radical surgery of gastric cancer. However, an accurate interpretation of the statistical interpretation between the different groups of patients is difficult, mainly because of the retrospective character of the study.
本研究的主要目的是评估至少接受D2淋巴结清扫术的胃癌患者的术后死亡率和5年生存率。
对1997年至2005年4月间在Fundeni临床研究所普通外科和肝移植科接受胃腺癌手术的1170例患者进行了回顾性研究。只有443例患者接受了根治性切除，其中216例患者进行了D1切除，227例患者进行了D2或D3/D4淋巴结清扫术。对于接受D1切除的患者中的189例以及接受D2或D3/D4淋巴结清扫术的患者中的210例，可获得生存信息。
根治性切除组的术后死亡率为6.5%，D1组为9.2%，D2/D3 D4组为3.9%。根据Kaplan Meier曲线，D1组的5年生存率为32%，而D2/D3-D4组为51.8%（p<0.0001）。中位生存期存在显著差异——D2/D3-D4组为63个月，D1组为28个月。
我们的数据支持在胃癌根治手术中至少进行D2淋巴结清扫术的胃切除术。然而，由于该研究的回顾性特点，很难对不同患者组之间的统计结果进行准确解读。
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