Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka, 411-8777, Japan.
Gastric Cancer. 2010 Aug;13(3):137-48. doi: 10.1007/s10120-010-0560-5. Epub 2010 Sep 5.
Gastric cancer is one of the leading causes of cancer-related death worldwide. Surgery is the only curative therapy for localized gastric cancer, but the extent of regional lymphadenectomy has been a matter of considerable debate. Extended resections that are regarded as standard procedures in some Asian countries, including Japan and Korea, have not been shown to be as effective in Western countries. The extent of lymphadenectomy for advanced gastric cancer has been studied in many prospective randomized controlled trials. On the other hand, patients with early gastric cancer have an excellent survival rate (>90%) after radical surgery. Lymph node metastasis from early gastric cancer is relatively infrequent. Therefore, it might be practical to perform less invasive surgery for early gastric cancer. In this review article, we examine the evidence for lymph node dissection as radical surgery in advanced gastric cancer and the possibility of limited resection for early gastric cancer.
胃癌是全球癌症相关死亡的主要原因之一。手术是局部胃癌的唯一治愈性治疗方法，但区域淋巴结清扫的范围一直是一个备受争议的问题。在一些亚洲国家，包括日本和韩国，广泛的切除术被认为是标准程序，但在西方国家并没有显示出同样的效果。在许多前瞻性随机对照试验中，已经研究了进展期胃癌的淋巴结清扫范围。另一方面，早期胃癌患者在根治性手术后的生存率非常高（>90%）。早期胃癌的淋巴结转移相对较少。因此，对于早期胃癌进行创伤更小的手术可能是可行的。在这篇综述文章中，我们研究了淋巴结清扫作为进展期胃癌根治性手术的证据，以及对早期胃癌进行有限切除的可能性。
