Baiocchi Gian Luca, Celotti Andrea, Molfino Sarah, Baggi Paolo, Tarasconi Antonio, Baronio Gianluca, Arru Luca, Gheza Federico, Tiberio Guido, Portolani Nazario
Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
Department of General and Minimally Invasive Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.
Transl Gastroenterol Hepatol. 2017 Jan 5;2:1. doi: 10.21037/tgh.2016.12.01. eCollection 2017.
This article aims at analyzing the published literature concerning the treatment of patients with gastric cancer and distant nodal metastases, actually considered metastatic disease. A systematic search was undertaken using Medline, Embase, Cochrane and Web-of-Science libraries. No specific restriction on year of publication was used; preference was given to English papers. Both clinical series and literature reviews were selected. Only 11 papers address the issue of surgery for nodal basins outside the D2 dissection area. From these papers, in selected cases extended surgery may prove useful in prolonging survival, when a comprehensive therapeutic pathway including chemotherapy is scheduled. In conclusion, in presence of nodal metastases outside the loco-regional nodes, surgery may be considered for metastatic nodes in stations 13 and 16, in selected cases.
本文旨在分析已发表的有关胃癌伴远处淋巴结转移（实际视为转移性疾病）患者治疗的文献。使用Medline、Embase、Cochrane和科学网数据库进行了系统检索。未对发表年份作特定限制；优先选择英文论文。同时选取了临床系列研究和文献综述。仅有11篇论文涉及D2清扫区域以外淋巴结区域的手术问题。从这些论文来看，在制定了包括化疗在内的综合治疗方案时，在某些选定病例中，扩大手术可能有助于延长生存期。总之，在存在区域淋巴结以外的淋巴结转移时，在某些选定病例中，可考虑对第13和16组转移淋巴结进行手术。
