可切除食管胃结合部腺癌的淋巴结转移和淋巴结清扫。
Lymph node metastasis and lymphadenectomy of resectable adenocarcinoma of the esophagogastric junction.
机构信息
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Chin J Cancer Res. 2014 Jun;26(3):237-42. doi: 10.3978/j.issn.1000-9604.2014.06.17.
Abstract
Based on Siewert classification, adenocarcinomas of the esophagogastric junction (AEGs) have different behaviors of perigastric-mediastinal nodal metastasis. Siewert type I AEGs have higher incidence of mediastinal nodal metastasis than those of type II or III, especially at middle-upper mediastinum. With regard to the necessity of mediastinal lymphadenectomy, theoretically, transthoracic esophagogastrectomy with complete mediastinal lymphadenectomy is suggested for Siewert type I AEGs, while transhiatal total gastrectomy with lower mediastinal and D2 perigastric lymphadenectomy is a standard surgery for type II-III AEGs. Nevertheless, the mediastinal nodal metastasis is an independent factor of poor prognosis for any type of AEG.
摘要
根据 Siewert 分类，食管胃结合部腺癌（AEG）具有不同的胃纵隔区域淋巴结转移行为。Siewert Ⅰ型 AEG 的纵隔淋巴结转移发生率高于Ⅱ型或Ⅲ型，尤其是中上部纵隔。关于纵隔淋巴结清扫的必要性，理论上，对于 Siewert Ⅰ型 AEG，建议行经胸食管胃切除术和完全纵隔淋巴结清扫术，而对于Ⅱ-Ⅲ型 AEG，标准手术为经腹贲门全胃切除术和下纵隔及 D2 胃周淋巴结清扫术。然而，纵隔淋巴结转移是任何类型 AEG 预后不良的独立因素。
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