Ikeda Y, Mori M, Kamakura T, Haraguchi Y, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Int Surg. 1995 Jul-Sep;80(3):208-10.
Three hundred and eleven patients with an R2 lymph node dissection for gastric cancer were reviewed in order to examine the efficacy of prophylactic R2 lymph node dissection. In 246 patients, who were all macroscopically determined to have either N0 or N1 lymph node metastasis at the time of operation, 30 showed histologic lymph node metastasis in the N2 group. When the 5-year survival rates in the 61 patients with histologic N2 lymph node metastasis were compared according to the macroscopic evaluation of lymph node metastasis at the time of operation, 30 patients who were determined to have either N0 or N1 lymph node metastasis showed a better prognosis than the 31 patients who were determined to have N2 lymph node metastasis (p < 0.01). Therefore, prophylactic R2 lymph node dissection contributes to an improved prognosis for gastric cancer patients who are found to macroscopically have either N0 or N1 lymph node metastasis on the basis of an intra-operative evaluation.
回顾性分析了311例行胃癌R2淋巴结清扫术的患者，以探讨预防性R2淋巴结清扫术的疗效。在246例患者中，所有患者在手术时经宏观判断均为N0或N1淋巴结转移，其中30例在N2组出现组织学淋巴结转移。当根据手术时淋巴结转移的宏观评估比较61例组织学N2淋巴结转移患者的5年生存率时，被判定为N0或N1淋巴结转移的30例患者的预后优于被判定为N2淋巴结转移的31例患者（p<0.01）。因此，对于术中评估宏观上为N0或N1淋巴结转移的胃癌患者，预防性R2淋巴结清扫术有助于改善其预后。
