Weed T E, Nuessle W, Ochsner A
Ann Surg. 1981 Apr;193(4):407-13. doi: 10.1097/00000658-198104000-00003.
Review of 298 cases of primary gastric malignancy from 1958 to 1978 revealed 265 cases of adenocarcinoma. Overall 5-year survival rate was a disappointing 5.5%, which was less than the earlier series of Oschner Clinic (7.5%). Curative resections produced a five-year survival rate of 26%. Patients presented with advanced disease; 84% had Stage III or IV disease at time of initial observation. The introduction of fiberoptic endoscopy during this period greatly enhanced the accuracy of preoperative diagnosis of tissue-proven cancer from 6% before fiberoptic to 58% since. Worldwide experience is much better, with overall five-year survival rate of 17.9%. Excellent survival statistics from Japanese studies reflect both the effects of mass surveying and early surgery and the prevalence of superficial spreading type of cancer. Improvement of results in this country will require more aggressive evaluation and earlier surgical intervention.
对1958年至1978年间298例原发性胃癌病例的回顾显示，其中有265例腺癌。总体5年生存率令人失望，仅为5.5%，低于奥施纳诊所早期系列研究的结果（7.5%）。根治性切除术的5年生存率为26%。患者就诊时多为晚期疾病；在初次观察时，84%的患者处于III期或IV期。在此期间，纤维内镜的引入极大地提高了术前经组织证实癌症诊断的准确性，从纤维内镜应用前的6%提高到了此后的58%。全球范围内的经验要好得多，总体5年生存率为17.9%。日本研究中出色的生存统计数据既反映了大规模筛查和早期手术的效果，也反映了浅表扩散型癌症的流行情况。在这个国家要改善治疗结果，需要更积极的评估和更早的手术干预。
