胃肿瘤分期中是否应将结肠直接侵犯纳入 T4？
Should direct mesocolon invasion be included in T4 for the staging of gastric cancer?
机构信息
Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
出版信息
J Surg Oncol. 2010 Mar 1;101(3):205-8. doi: 10.1002/jso.21476.
BACKGROUND AND OBJECTIVES
One of the sites most frequently invaded by gastric cancer is the mesocolon; however, the UICC does not mention this anatomical site as an adjacent structure involved in gastric cancer. The purpose of this study was to characterize and classify mesocolon invasion from gastric cancer.
METHODS
We examined 806 patients who underwent surgery for advanced gastric carcinoma from 1992 to 2007 at the Department of Surgery, Gangnam Severance Hospital, Korea. Among these, patients who showed macroscopically direct invasion into the mesocolon were compared to other patients with advanced gastric cancer.
RESULTS
The curability, number and extent of nodal metastasis, and the survival of the mesocolon invasion group were significantly worse than these factors in the T3 group. However, the survival of the mesocolon invasion group after curative resection was much better than that of patients who had incurable factors.
CONCLUSIONS
Mesocolon invasion should be included in T4 for the staging of gastric cancer.
背景与目的
胃癌最常侵犯的部位之一是横结肠系膜，但 UICC 并未将该解剖部位视为与胃癌相关的毗邻结构。本研究旨在对胃癌的横结肠系膜侵犯进行特征描述和分类。
方法
我们对 1992 年至 2007 年在韩国江南塞弗伦斯医院外科接受手术治疗的 806 例晚期胃癌患者进行了检查。其中，对表现为横结肠系膜肉眼直接侵犯的患者与其他晚期胃癌患者进行了比较。
结果
系膜侵犯组的可治愈性、淋巴结转移的数量和范围以及生存率均显著差于 T3 组。然而，根治性切除术后系膜侵犯组的生存率明显优于不可治愈因素的患者。
结论
横结肠系膜侵犯应被纳入胃癌的 T4 分期。
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