Noguchi M, Miyazaki I
Department of Surgery II, Kanazawa University Hospital, Japan.
Br J Surg. 1996 Feb;83(2):156-61.
Regional lymph node metastasis is a critical prognostic factor in gastric cancer, and extended lymph node dissection and routine microscopic examination of all resected nodes could potentially provide accurate information regarding lymph node status. On the other hand, the therapeutic value of extended lymph node dissection is controversial. While retrospective and prospective nonrandomized comparative studies have shown that extended lymph node dissection significantly improves the survival rate, two prospective randomized trials have failed to demonstrate the efficacy of extended dissection, although the number of patients in these studies was limited. There is a further, ongoing, trial involving a larger series of patients; the final results of this study should help to determine whether extended lymph node dissection is of therapeutic or merely prognostic value in gastric cancer.
区域淋巴结转移是胃癌的一个关键预后因素，扩大淋巴结清扫术以及对所有切除淋巴结进行常规显微镜检查可能会提供有关淋巴结状态的准确信息。另一方面，扩大淋巴结清扫术的治疗价值存在争议。虽然回顾性和前瞻性非随机对照研究表明扩大淋巴结清扫术能显著提高生存率，但两项前瞻性随机试验未能证明扩大清扫术的疗效，尽管这些研究中的患者数量有限。还有一项正在进行的试验涉及更多患者；这项研究的最终结果应有助于确定扩大淋巴结清扫术在胃癌中是具有治疗价值还是仅仅具有预后价值。
