Maehara Y, Okuyama T, Oshiro T, Baba H, Anai H, Akazawa K, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Gynecol Obstet. 1993 Dec;177(6):593-7.
We analyzed data on 423 Japanese patients with early carcinoma of the stomach with respect to clinicopathologic features and prognosis. All patients were treated in the clinics at which we work. The upper one-third of the stomach was less frequently involved. Therefore, partial gastrectomy was performed more often in patients with early carcinoma of the stomach than in those with advanced carcinoma of the stomach. The differentiated type of carcinoma of the stomach was more frequent and grew expansively. Lymph node metastasis was noted in 11.6 percent of the patients, lymphatic vessel involvement was evident in 13.5 percent and extensive lymph node dissection (R2 or R3) was performed in 86.0 percent. The 15 year survival rate for patients with early carcinoma of the stomach was 89.0 percent. Lymph node metastasis, differentiated tumor type and patient age proved to be independent prognostic factors, as determined by multivariate analysis. Increased detection of early carcinoma of the stomach in its curable stages may be achieved through gastrointestinal series and endoscopy for symptomatic patients. A close follow-up evaluation is essential to detect recurrences, even when a curative resection is performed.
我们分析了423例日本早期胃癌患者的临床病理特征及预后数据。所有患者均在我们工作的诊所接受治疗。胃的上三分之一受累较少。因此,早期胃癌患者行胃部分切除术的频率高于进展期胃癌患者。胃的分化型癌更为常见且呈膨胀性生长。11.6%的患者出现淋巴结转移,13.5%有淋巴管受累,86.0%的患者进行了广泛淋巴结清扫(R2或R3)。早期胃癌患者的15年生存率为89.0%。多因素分析显示,淋巴结转移、肿瘤分化类型和患者年龄是独立的预后因素。对于有症状的患者,通过胃肠钡餐造影和内镜检查可提高早期胃癌在可治愈阶段的检出率。即使进行了根治性切除,密切的随访评估对于发现复发也至关重要。