Madden M V, Price S K, Learmonth G M, Dent D M
Br J Surg. 1987 Feb;74(2):119-21. doi: 10.1002/bjs.1800740217.
Macroscopic 'TNM' staging was performed during 78 consecutive operations for gastric carcinoma and compared with subsequent pathological staging. Surgical assessment was correct for tumour (T) in 60 per cent when depth of invasion was assessed, for nodes (N) in 61 per cent, for liver metastases (M) in 92 per cent but for all aspects in only 21 per cent. Curability (conservatively defined as T1-3, N0-1, M0) was correct in 8 of 18 patients thus assessed at surgery and incurability was pathologically correct in 58 of 60 patients. Despite inaccurate surgical staging, no patient was denied a resection although 10 patients had unduly radical procedures for their stage and 2 had inappropriately conservative procedures for their stage (but without evidence of residual disease). Staging errors did not jeopardize conventional surgical management substantially and use of intra-operative microscopic sampling of nodes would have improved surgical treatment only minimally.
对78例连续性胃癌手术进行了宏观“TNM”分期，并与随后的病理分期进行比较。当评估浸润深度时，手术评估对肿瘤（T）分期的正确率为60%，对淋巴结（N）分期的正确率为61%，对肝转移（M）分期的正确率为92%，但对所有方面分期正确的仅为21%。在手术中如此评估的18例患者中，有8例的可治愈性（保守定义为T1 - 3、N0 - 1、M0）评估正确，在60例患者中，有58例的不可治愈性经病理证实正确。尽管手术分期不准确，但没有患者被拒绝手术切除，不过有10例患者接受了超出其分期的过度根治性手术，2例患者接受了与其分期不相符的过于保守的手术（但无残留疾病证据）。分期错误并未对传统手术治疗造成实质性影响，术中对淋巴结进行显微镜下采样仅能在极小程度上改善手术治疗。
