Lisborg P, Jatzko G, Horn M, Neumann H J, Müller M, Stettner H, Denk H
Surgical Dept., Hospital of Barmherzigen Brüder, St. Veit/Glan, Austria.
Scand J Gastroenterol. 1994 Nov;29(11):1024-8. doi: 10.3109/00365529409094880.
Extended lymphadenectomy remains controversial in the Western world. Its evaluation and the identification of high-risk patients after surgery are important tasks.
A retrospective prognostic study of 318 patients treated for potential cure of gastric cancer was performed. All patients underwent extended lymphadenectomy. Clinical histopathologic and surgical factors were examined for their influence on survival by univariate and multivariate analysis.
Postoperative mortality was 4.4% (14 of 318), and the 5-year adjusted survival rate was 57.8%. Multivariate analysis using the Cox model identified seven factors as having independent influence on survival. Detrimental factors were male gender, age over 65 years, high pN category, increasing number of lymph nodes invaded by metastases, total gastric resection, splenectomy, and increasing number of perioperatively required blood units.
Extended lymphadenectomy was possible without sacrificing low postoperative mortality rates. The importance of certain prognostic factors, in particular lymph node status, could be confirmed.
在西方世界，扩大淋巴结清扫术仍存在争议。对其进行评估以及识别术后高危患者是重要任务。
对318例接受胃癌潜在根治性治疗的患者进行回顾性预后研究。所有患者均接受扩大淋巴结清扫术。通过单因素和多因素分析，研究临床组织病理学和手术因素对生存的影响。
术后死亡率为4.4%（318例中的14例），5年校正生存率为57.8%。使用Cox模型进行的多因素分析确定了七个对生存有独立影响的因素。不利因素包括男性、年龄超过65岁、高pN分期、转移侵袭的淋巴结数量增加、全胃切除、脾切除以及围手术期所需血制品数量增加。
扩大淋巴结清扫术在不牺牲低术后死亡率的情况下是可行的。某些预后因素的重要性，尤其是淋巴结状态，可以得到证实。
