Ti T K
Division of Gastro-intestinal Surgery, National University Hospital, Singapore.
Ann Acad Med Singap. 1993 Mar;22(2):146-50.
A personal series of 160 patients with gastric cancer operated over a twelve-and-a-half-year period in Singapore is reviewed. Cancer occurred in the antrum and/or body of stomach in 125 patients. Surgical resections were performed on 125 patients, 53 of which were palliative. Attempted cure by R2 type radical resection was performed on 72 patients--14 patients with Stage I disease, 13 patients with Stage II disease and 45 patients with Stage III disease. There was no operative mortality in these 72 patients. In the cohort of 89 patients operated more than five years ago, six patients with cancer of cardia and 33 patients with cancer of gastric antrum and/or body underwent curative resection. There were 13 known five-year survivors amongst these latter 33 patients; 20 of these patients had Stage III disease and six of these were five-year survivors. Gastric cancer in Singapore continues to present at a late stage of disease. Though apparently falling short of the excellent results reported from Japan, our preliminary five-year survival figures compare favourably with many Western series. The existence of different biological forms of cancer has been suggested to be an important factor to explain the wide difference in results. However, perhaps of greater importance is the extent of surgical resection--R2 type resection having improved prospects of cure in a disease notorious for its poor prognosis.
回顾了在新加坡12年半期间接受手术的160例胃癌患者的个人系列病例。125例患者的癌症发生在胃窦和/或胃体。125例患者接受了手术切除，其中53例为姑息性手术。72例患者尝试进行R2型根治性切除以达到治愈目的——14例I期疾病患者、13例II期疾病患者和45例III期疾病患者。这72例患者中无手术死亡病例。在5年多前接受手术的89例患者队列中，6例贲门癌患者和33例胃窦和/或胃体癌患者接受了根治性切除。在这33例患者中有13例已知的5年生存者；其中20例患者为III期疾病，其中6例为5年生存者。新加坡的胃癌仍在疾病晚期出现。虽然显然未达到日本报道的优异结果，但我们初步的5年生存率数据与许多西方系列相比具有优势。有人提出癌症存在不同生物学形式是解释结果差异巨大的一个重要因素。然而，也许更重要的是手术切除范围——R2型切除改善了一种预后极差疾病的治愈前景。
