[胃癌——从外科手术角度看当前形势]

[Stomach cancer--the current situation from the surgical viewpoint].

作者信息

Siewert J R, Lange J, Böttcher K, Hölscher M, Weiser H F, Gössner W

出版信息

Dtsch Med Wochenschr. 1987 Apr 17;112(16):622-8. doi: 10.1055/s-2008-1068109.

DOI:10.1055/s-2008-1068109

Abstract

From July 1st 1982 to December 31st 1986, 359 patients with a histologically confirmed gastric carcinoma were operated on. At the beginning of therapy, 44.3% were in the pathological anatomical stages I and II, 55.7% in stages III and IV (UICC 1987). 307 patients could be resected (resection rate 85.5%). The proportion of R0 resections (no residual tumor) was 61.9%, R1 resections (microscopically demonstrable tumor residues) 23.1% and R2 resections (macroscopical tumor residues) 15%. Overall, a curative resection could be carried out in 61.9% of the cases and a palliative resection in 38.1% of the cases. In 21.5%, a subtotal gastric resection, in 48.2% a total gastrectomy and in 30.3% an extended total gastrectomy was necessary in addition. The lethality was 3.0% for subtotal resection, 5.4% for the simple total gastrectomy and 9.6% for the extended total gastrectomy. The prognosis corresponds to the tumor stage at the beginning of therapy (three year actuarial survival: stage I 76%, stage II and III 26%, stage IV 7%).

摘要

1982年7月1日至1986年12月31日，359例经组织学确诊为胃癌的患者接受了手术治疗。治疗开始时，44.3%处于病理解剖分期I期和II期，55.7%处于III期和IV期（国际抗癌联盟1987年分期标准）。307例患者可行手术切除（切除率85.5%）。R0切除（无残留肿瘤）的比例为61.9%，R1切除（显微镜下可见肿瘤残留）为23.1%，R2切除（肉眼可见肿瘤残留）为15%。总体而言，61.9%的病例可行根治性切除，38.1%的病例可行姑息性切除。另外，21.5%的病例需要行胃次全切除术，48.2%需要行全胃切除术，30.3%需要行扩大全胃切除术。胃次全切除的死亡率为3.0%，单纯全胃切除的死亡率为5.4%，扩大全胃切除的死亡率为9.6%。预后与治疗开始时的肿瘤分期相关（三年精算生存率：I期76%，II期和III期26%，IV期7%）。