Ikeguchi M, Ohfuji S, Oka A, Tsujitani S, Maeta M, Kaibara N
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
J Surg Oncol. 1995 Feb;58(2):83-90. doi: 10.1002/jso.2930580203.
The prognosis of patients with gastric cancer with esophageal invasion is extremely poor. To evaluate factors related to this poor prognosis, we analyzed 200 patients with gastric cancer located in the upper third of the stomach. These patients underwent gastrectomy and were divided into two groups in terms of the presence (E[+] group; n = 62) or absence (E[-] group; n = 138) of histological evidence of esophageal invasion. Even when apparently curative surgery was performed, the 5-year survival rate of patients with E[+] gastric cancer (45.8%) was significantly lower than of patients with E[-] gastric cancer (71.6%). In the E[+] group, the 5-year survival rate of patients who had tumors with infiltrative growth and DNA aneuploidy was only 10.0%. These patients had a high frequency of peritoneal metastasis at operation (5/16; 31.3%); even when apparently curative operations were performed, 50% of these patients died from peritoneal metastatic recurrence within 2 years after surgery. Gastric adenocarcinoma with esophageal invasion accompanied by infiltrative growth and DNA aneuploidy had a high potential for peritoneal metastasis. This combination is associated with the most pessimistic prognosis for patients with gastric cancer with esophageal invasion.
伴有食管侵犯的胃癌患者预后极差。为评估与这种不良预后相关的因素，我们分析了200例位于胃上三分之一部位的胃癌患者。这些患者接受了胃切除术，并根据是否存在食管侵犯的组织学证据分为两组（食管侵犯阳性组，n = 62；食管侵犯阴性组，n = 138）。即使进行了看似根治性的手术，食管侵犯阳性的胃癌患者的5年生存率（45.8%）也显著低于食管侵犯阴性的胃癌患者（71.6%）。在食管侵犯阳性组中，肿瘤呈浸润性生长且DNA非整倍体的患者的5年生存率仅为10.0%。这些患者手术时腹膜转移的发生率很高（5/16；31.3%）；即使进行了看似根治性的手术，这些患者中有50%在术后2年内死于腹膜转移复发。伴有浸润性生长和DNA非整倍体的伴有食管侵犯的胃腺癌具有很高的腹膜转移潜能。这种组合与伴有食管侵犯的胃癌患者最悲观的预后相关。
