Boddie A W, McMurtrey M J, Giacco G G, McBride C M
Cancer. 1983 Apr 1;51(7):1195-200. doi: 10.1002/1097-0142(19830401)51:7<1195::aid-cncr2820510705>3.0.co;2-v.
In the interval from 1941-1981 when 1887 patients with gastric cancer were seen at The University of Texas System Cancer Center M.D. Anderson Hospital and Tumor Institute, 151 curative and 45 palliative total gastrectomies or esophagogastrectomies were performed. Over the same interval, 21 patients with extent of primary and metastatic tumor roughly comparable to that seen in the palliative resection group were treated by exploration only or, infrequently, by attempted bypass. In individual patients subtle differences in extent of disease as well as differences in philosophy of the operating surgeon regarding the value of palliative resection undoubtedly contributed to the procedure selected. Survival after curative resection was greater than after palliative resection which in turn was greater than survival after exploration bypass (P less than or equal to .0006). Operative mortality fell significantly in CR patients in the interval 1970-1981 compared to 1941-1969 and was significantly lower than in the PR group in the interval 1970-1981 (P less than or equal to 0.01). Five-year survival increased significantly (P less than or equal to 0.03) in the CR group when results in the two time intervals were compared but not in other groups.
在1941年至1981年期间，德克萨斯大学系统癌症中心M.D.安德森医院和肿瘤研究所共收治了1887例胃癌患者，其中151例行根治性全胃切除术或食管胃切除术，45例行姑息性全胃切除术或食管胃切除术。在同一时期，有21例患者，其原发性和转移性肿瘤的范围与姑息性切除组大致相当，仅接受了探查，或偶尔尝试进行旁路手术。在个别患者中，疾病范围的细微差异以及手术医生对姑息性切除价值的理念差异无疑导致了所选择的手术方式。根治性切除后的生存率高于姑息性切除，而姑息性切除又高于探查旁路后的生存率（P≤0.0006）。与1941年至1969年相比，1970年至1981年期间根治性切除患者的手术死亡率显著下降，且在1970年至1981年期间显著低于姑息性切除组（P≤0.01）。当比较两个时间段的结果时，根治性切除组的五年生存率显著提高（P≤0.03），但其他组没有。
