Meyer H J, Jähne J, Wilke H, Pichlmayr R
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover.
Zentralbl Chir. 1995;120(2):128-34.
In spite of standardization of surgical procedures in the treatment of gastric carcinomas including increased resection rates as well as decreased postoperative mortality long-term survival rates are poor. An improvement of the prognosis by surgery alone can be expected only by tumor free R0-resection. In locally advanced gastric carcinomas with questionable R0-resection some studies could show promissing results using preoperative chemotherapy. This treatment modality enabled increased R0-resection rates with a positive impact on median survival in relation to surgery alone. Randomized trials have to start in the future to verify or to modify these results incorporating new options of multimodality treatment.
尽管胃癌治疗的手术程序已标准化,包括切除率提高以及术后死亡率降低,但长期生存率仍很低。仅通过手术改善预后,只有在实现无瘤R0切除的情况下才有望实现。在R0切除存在疑问的局部晚期胃癌中,一些研究表明术前化疗取得了可喜的结果。这种治疗方式提高了R0切除率,对中位生存期产生了积极影响,相对于单纯手术而言。未来必须开展随机试验,以验证或修改这些结果,并纳入新的多模式治疗方案。