Larson G M
Am Surg. 1983 Feb;49(2):105-9.
The case records of 101 patients operated on for adenocarcinoma of the stomach at one hospital over a 25-year period were reviewed. Generally, the patients had advanced disease (80% had Stage III or Stage IV tumors) at the time of treatment. Curative procedures were possible in only 46 patients and yielded a five-year survival rate of 16.7 per cent. The overall operative mortality rate was 25 per cent, although in the last decade that rate decreased to 15 per cent. Good palliation in the early months was achieved with both subtotal gastric resection and bypass gastrojejunostomy. Because of patient selection, however, the palliation provided by bypass was of shorter duration (mean less than six months). The main reason for these disappointing results was the advanced stage of the cancer at the time of diagnosis and treatment. The prognosis for patients with gastric cancer clearly correlates with the stage of the disease at the time of operation. Surgical resection provides the most effective relief of symptoms and offers the only hope of cure. The importance of diagnosing gastric cancer early when the tumor is still confined to the stomach wall is emphasized and recommendations for achieving this goal are discussed.
对一家医院在25年期间接受胃癌腺癌手术的101例患者的病例记录进行了回顾。一般来说，这些患者在治疗时病情已属晚期（80%患有III期或IV期肿瘤）。只有46例患者可行根治性手术，五年生存率为16.7%。总体手术死亡率为25%，不过在过去十年中该比率降至15%。胃次全切除术和胃空肠吻合术在最初几个月都能实现良好的姑息治疗。然而，由于患者选择的原因，旁路手术提供的姑息治疗持续时间较短（平均不到六个月）。这些令人失望结果的主要原因是诊断和治疗时癌症已处于晚期。胃癌患者的预后显然与手术时疾病的分期相关。手术切除能最有效地缓解症状，也是治愈的唯一希望。强调了在肿瘤仍局限于胃壁时早期诊断胃癌的重要性，并讨论了实现这一目标的建议。
