Hundahl Scott A, Peeters Koen C M J, Kranenbarg E Klein, Hartgrink Henk, van de Velde Cornelis J H
Department of Surgery, University of California at Davis, CA, USA.
Gastric Cancer. 2007;10(2):84-6. doi: 10.1007/s10120-007-0426-7. Epub 2007 Jun 25.
Based on more than 11 years of follow-up, autopsy-based analysis of recurrence in the Dutch D1-D2 Trial permits meaningful assessment of patterns of failure with respect to the Maruyama Index (MI). We previously reported that a low Maruyama Index was an independent predictor of both overall and disease-specific survival. Autopsy results are available for 441 deaths on study. Distant-only failure (15% vs 13%) was no different between the MI categories, but isolated "regional" failure (8% for MI < 5 group vs 21%) and "regional + distant" failure (19% for MI < 5 group vs 36%) occurred less frequently in the MI < 5 group (P < 0.001). We conclude that "low Maruyama Index" surgery enhances regional control and survival but does not alter the occurrence of isolated distant metastases unassociated with regional failure. Our results speak to the substantial survival value of local-regional control in this disease.
基于超过11年的随访，对荷兰D1 - D2试验中基于尸检的复发情况分析，有助于对与丸山指数（MI）相关的失败模式进行有意义的评估。我们之前报道过，低丸山指数是总生存和疾病特异性生存的独立预测因素。本研究中有441例死亡病例的尸检结果可供分析。在不同MI类别中，单纯远处转移失败率（分别为15%和13%）无差异，但孤立的“区域”转移失败（MI < 5组为8%，而另一组为21%）和“区域 + 远处”转移失败（MI < 5组为19%，而另一组为36%）在MI < 5组中发生率更低（P < 0.001）。我们得出结论，“低丸山指数”手术可增强区域控制和提高生存率，但不会改变与区域转移失败无关的孤立远处转移的发生率。我们的结果表明了局部区域控制在这种疾病中的显著生存价值。
