胃癌的外科治疗结果——特别提及病理检查结果

Results of surgical treatment of gastric cancer--special reference to pathological findings.

作者信息

Yoshida K, Ikeuchi H, Kano K, Machida T, Takahashi M, Miura Y, Miura N

出版信息

Tohoku J Exp Med. 1984 Sep;144(1):57-62. doi: 10.1620/tjem.144.57.

DOI:10.1620/tjem.144.57

Abstract

During 16 year period from 1967 to 1982, a total of 1,471 patients with gastric cancer were surgically treated at the authors' clinic and 1,347 of them underwent gastric resection. The 5-year survival rate for 692 of curatively operated patients was 73.8%, in contrast to 11.8% for non-curatively operated cases. A correlation study disclosed the depth of cancer infiltration and the extent of lymphnode metastasis to be most reliable prognostic factors. The 5-year survival rate for stage I cases was 91.0%, 70.0% for stage II, 46.7% for stage III, and 8.6% for stage IV. An improvement in the end-results was attributed mainly to the increased incidence of early cancer in surgical cases, and partially to proper adjuvant chemotherapy for the advanced cancer cases during or long-term after surgery. In fact, the cases of early gastric carcinoma whose depth invasion was limited within the mucosa or submucosa constituted 41.9% of the authors' surgical series in 1967-1982, and 5-year survival rates of patients in stages II, III and IV receiving cancer chemotherapy strikingly improved to 80.6%, 57.3%, and 13.2%, in contrast to 59.7%, 35.2% and 2.4% for control groups not treated with anticancer agents.

摘要

在1967年至1982年的16年期间，作者所在诊所共对1471例胃癌患者进行了手术治疗，其中1347例行胃切除术。692例根治性手术患者的5年生存率为73.8%，而非根治性手术患者的5年生存率为11.8%。一项相关性研究表明，癌浸润深度和淋巴结转移范围是最可靠的预后因素。I期病例的5年生存率为91.0%，II期为70.0%，III期为46.7%，IV期为8.6%。最终结果的改善主要归因于手术病例中早期癌发病率的增加，部分归因于对晚期癌症病例在手术期间或术后长期进行适当的辅助化疗。事实上，在1967 - 1982年作者的手术系列中，浸润深度局限于黏膜或黏膜下层的早期胃癌病例占41.9%，接受癌症化疗的II期、III期和IV期患者的5年生存率显著提高至80.6%、57.3%和13.2%，而未接受抗癌药物治疗的对照组分别为59.7%、35.2%和2.4%。