Matsusaka T, Mitsudomi T, Wakasugi K, Takenaka M, Kume K, Fujinaga Y, Teraoka H, Fuchigami T, Iwashita A
Dept. of Surgery, Matsuyama Red Cross Hospital.
Gan No Rinsho. 1988 Nov;34(14):1943-50.
In this paper we have studied 649 resected cases of S0 (macroscopically negative serosal invasion) gastric cancer, this number of S0 gastric cancer resections experienced from a total number of 1692 patients treated at our hospital during the previous 16 years. The five-year survival rate of S0 cancers was 94% for patients given curative resections. Most of S0 cancers were histologically restricted within the pm layer but a few had reached the ss gamma or se layer. Non-curative factors in S0 cancers we recomposed of cancer positive stumps in the IIb-like margin, liver metastasis in the differentiated type carcinomas with ss invasion, and surgically left lymph node metastasis in the advanced carcinomas. As for lymph node dissections, our study reveals that an R2 dissection in the C and M regions, and a R3 or R2 + No.12 dissection for the A region are recommended. Modes of recurrence were characterized by liver or other hematogeneous metastasis in pm cancers or lymph node-positive cancers at the antrum, and by a peritoneal recurrence at the corpus in cases of advanced cancers. Histological ps(-) cancers showed a different survival result than did the S0 cancers and S(+) cancers.
在本文中，我们研究了649例S0期（宏观上无浆膜侵犯）胃癌的切除病例，这649例S0期胃癌切除病例来自于我院在过去16年中治疗的1692例患者。接受根治性切除的S0期癌症患者的五年生存率为94%。大多数S0期癌症在组织学上局限于黏膜下层，但少数已累及浆膜下γ层或浆膜层。我们将S0期癌症的非根治性因素重新归纳为IIb样切缘癌阳性残端、伴有浆膜下侵犯的分化型癌肝转移以及进展期癌手术残留淋巴结转移。关于淋巴结清扫，我们的研究表明，推荐在C区和M区进行R2清扫，在A区进行R3或R2 + 12组淋巴结清扫。复发模式的特点是，黏膜下层癌或胃窦部淋巴结阳性癌以肝转移或其他血行转移为主，而进展期癌胃体部则以腹膜复发为主。组织学上ps(-)癌的生存结果与S0期癌和S(+)癌不同。
