Tokunaga Masanori, Ohyama Shigekazu, Hiki Naoki, Fukunaga Tetsu, Yamamoto Noriko, Yamaguchi Toshiharu
Department of Gastroenterology Surgery, Japanese foundation for Cancer Research, Tokyo, Japan.
Hepatogastroenterology. 2011 Jul-Aug;58(109):1224-8. doi: 10.5754/hge10018.
BACKGROUND/AIMS: Surgical R0 resection is a mainstay of treatment for gastrointestinal stromal tumor (GIST) of the stomach. The incidence of lymph node metastasis (LNM) has been reported as extremely low. However, the actual incidence of LNM still remains unclear due to the limited number of patients who underwent systemic lymph node dissection.
Fifty-seven patients who underwent gastrectomy with systemic lymphadenectomy for c-Kit-positive GIST of the stomach at the Cancer Institute Hospital between 1970 and 2000 were included. The clinicopathological characteristics of the patients were used to clarify the incidence and prognostic value of LNM in patients with GIST of the stomach.
R0 resection was achieved in 52/57 patients. The 5-year survival rate of patients following R0 resection was 68.6%. LNM was observed in 5/57 (8.8%) patients. All 5 patients died within 5 years after surgery even though 3 had undergone curative surgery.
In patients with GIST of the stomach, the incidence of LNM following systemic lymphadenectomy is low. The prognosis of patients with LNM was poor; thus it should be regarded as an advanced disease.
背景/目的：手术R0切除是胃胃肠道间质瘤（GIST）治疗的主要手段。据报道，胃GIST的淋巴结转移（LNM）发生率极低。然而，由于接受系统性淋巴结清扫的患者数量有限，LNM的实际发生率仍不清楚。
纳入1970年至2000年间在癌症研究所医院接受胃c-Kit阳性GIST胃切除术并系统性淋巴结清扫的57例患者。利用患者的临床病理特征来阐明胃GIST患者LNM的发生率及预后价值。
57例患者中有52例实现了R0切除。R0切除术后患者的5年生存率为68.6%。57例患者中有5例（8.8%）观察到LNM。尽管3例接受了根治性手术，但所有5例患者均在术后5年内死亡。
在胃GIST患者中，系统性淋巴结清扫术后LNM的发生率较低。LNM患者的预后较差，因此应将其视为晚期疾病。
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