Sasako M, McCulloch P, Kinoshita T, Maruyama K
Department of Surgical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Br J Surg. 1995 Mar;82(3):346-51. doi: 10.1002/bjs.1800820321.
The results of 1281 potentially curative resections for advanced gastric cancer performed at the National Cancer Center Hospital between 1972 and 1986 were studied using a novel approach which circumvents the stage migration phenomenon. The incidence of metastasis and the 5-year survival rate of patients with positive nodes were calculated independently for each lymph node 'station', without any reference to overall pathological nodal stage. The therapeutic value of extended lymph node dissection was estimated by multiplication of incidence of metastasis and percentage 5-year survival rate of patients with metastasis for each station. The incidence of metastasis ranged from 2.4 per cent to 66 per cent and the 5-year survival rate of affected patients from 0 to 58.7 per cent in perigastric stations, depending on the site of the primary tumour. The incidence of metastasis was between 3.0 per cent and 44.4 per cent in the second tier of nodes (n2), and the 5-year survival rate ranged from 0 per cent to 47.5 per cent. The majority of second-tier stations showed evidence of benefit from node dissection.
采用一种避免分期迁移现象的新方法，对1972年至1986年间在国立癌症中心医院进行的1281例晚期胃癌潜在根治性切除术的结果进行了研究。对于每个淋巴结“站”，独立计算转移发生率和淋巴结阳性患者的5年生存率，而不考虑总体病理淋巴结分期。通过将每个站的转移发生率与发生转移患者的5年生存率百分比相乘，来评估扩大淋巴结清扫术的治疗价值。根据原发肿瘤的部位，胃周各站的转移发生率在2.4%至66%之间，受累患者的5年生存率在0至58.7%之间。在第二站淋巴结（n2）中，转移发生率在3.0%至44.4%之间，5年生存率在0%至47.5%之间。大多数第二站显示出淋巴结清扫术有益的证据。
