Miholic J, Moeschl P, Schwarz C, Klepetko W, Neuhold N, Scheiber V, Stellwag-Carion F, Wolner E
II. Chirurgische Universitätsklinik, Universität Wien.
Chirurg. 1987 Oct;58(10):656-62.
Among 164 patients operated upon for adenocarcinoma of the cardia 102 (61%) were resected, 87 of them with curative intent. The mortality within 30 days was 20%, and the 5-year survival 15%. A total gastrectomy was performed in 36 patients, whereas a proximal partial gastrectomy was carried out in 66 cases. The median survival was 19 months after total gastrectomy, and 11 months after proximal resection (Breslow: 0.22). Only in stages N0 and N1 total gastrectomy resulted in a significantly longer (32 months) median survival than proximal resection (11 months; p = 0.03). The impact of total gastrectomy was more pronounced in the diffuse type according to Lauren, whereas lymphadenectomy was more effective in stages N0 and N1 and in Lauren's intestinal type. It is concluded that total gastrectomy should be carried out in all cases of carcinoma of the cardia.
在164例接受贲门腺癌手术的患者中，102例（61%）接受了切除手术，其中87例的手术目的是治愈。30天内的死亡率为20%，5年生存率为15%。36例患者接受了全胃切除术，66例进行了近端胃部分切除术。全胃切除术后的中位生存期为19个月，近端切除术后为11个月（Breslow：0.22）。仅在N0和N1期，全胃切除术的中位生存期（32个月）明显长于近端切除术（11个月；p = 0.03）。根据Lauren分类，全胃切除术对弥漫型的影响更为明显，而淋巴结清扫术在N0和N1期以及Lauren肠型中更有效。结论是，所有贲门癌病例均应进行全胃切除术。
