Wolff H, Lorf T
Klinik für Chirurgie, Bereichs Medizin (Charité), Humboldt-Universität zu Berlin.
Zentralbl Chir. 1989;114(14):900-8.
Accurate staging by unambiguously defined, comparable criteria is essential for a phase-adjusted therapeutic concept to cope with gastric carcinoma. Decision-making on gastrectomy or subtotal gastric resection has to depend primarily on tumour localisation and prognosis by histological classification according to Laurén. Between January 1, 1980, and May 1, 1988, operations for gastric carcinoma were performed on 203 patients at the Surgical Department of Charité, with gastric resection being applied to 144 of them. Postoperative lethality amounted to nine per cent. Indications were established in 66 cases for gastrectomy and in 78 patients for subtotal gastric resection. Two-year survival rates were 52 per cent for the intestinal cell type and 35 per cent for the diffuse type. Prognosis can be improved by radical resection and extensive lymph node removal at the first two lymph node stages. Resection of other infiltrated organ regions may quite often prove necessary for oncological radicality. Splenectomy will be chosen for stomach carcinomas localised in the upper and medium thirds or in tumour stages III and IV.
通过明确界定、可比的标准进行准确分期，对于调整阶段的胃癌治疗理念至关重要。胃切除术或胃大部切除术的决策主要取决于肿瘤定位以及根据劳伦组织学分类的预后情况。1980年1月1日至1988年5月1日期间，柏林夏里特医院外科对203例胃癌患者进行了手术，其中144例行胃切除术。术后死亡率为9%。66例患者的手术指征为胃切除术，78例患者为胃大部切除术。肠细胞型的两年生存率为52%，弥漫型为35%。在前两个淋巴结阶段进行根治性切除和广泛淋巴结清扫可改善预后。为实现肿瘤根治性，常常需要切除其他受浸润的器官区域。对于位于上三分之一和中三分之一或处于III期和IV期肿瘤阶段的胃癌，将选择行脾切除术。
