Wilson N V, Geall A, Kittermaster R, Bentley P G
Department of Surgery, Kent & Sussex Hospital, Tunbridge Wells, Kent.
Ann R Coll Surg Engl. 1990 Sep;72(5):329-34.
A series of 47 consecutive patients with adenocarcinoma of the gastric cardia presenting between 1982 and 1987 have been reviewed. Of these, 38 patients were eligible for surgery (operability rate of 80.85%) but only 25 patients underwent potentially curative resection (resection rate of 65.7%). The disease was extensive at the time of operation, with only two patients (8%) having node negative tumours. The mean hospital stay for patients undergoing resection was 21 days. There were 15 major complications in 10 patients undergoing resection, but a zero 30-day mortality rate. The prognosis of those patients undergoing radical resection remains dismal. No patient survived longer than 30 months, 80% were dead within 1 year. Tumour recurrence and metastases were documented in 13 patients (52%). In the unresectable group there were two deaths from intubation (9%). The mean hospital stay for this group of patients was 12 days. The mean duration of survival in the group was 5.4 months, 70% of patients dying within 6 months and 95% dead within 1 year. The value of radical surgery in patients with adenocarcinoma of the gastric cardia is questioned.
回顾了1982年至1987年间连续收治的47例贲门腺癌患者。其中，38例患者符合手术条件（可手术率为80.85%），但仅25例患者接受了潜在根治性切除（切除率为65.7%）。手术时疾病已广泛扩散，只有2例患者（8%）肿瘤无淋巴结转移。接受切除手术的患者平均住院时间为21天。10例接受切除手术的患者出现了15例严重并发症，但30天死亡率为零。接受根治性切除的患者预后仍然很差。没有患者存活超过30个月，80%的患者在1年内死亡。13例患者（52%）出现肿瘤复发和转移。在不可切除组中，有2例患者因插管死亡（9%）。该组患者的平均住院时间为12天。该组患者的平均生存时间为5.4个月，70%的患者在6个月内死亡，95%的患者在1年内死亡。贲门腺癌患者根治性手术的价值受到质疑。
