无淋巴结转移胃癌的外科治疗及结果

Surgical treatment and outcome for node-negative gastric cancer.

作者信息

Maehara Y, Tomoda M, Tomisaki S, Ohmori M, Baba H, Akazawa K, Sugimachi K

机构信息

Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Surgery. 1997 Jun;121(6):633-9. doi: 10.1016/s0039-6060(97)90051-9.

DOI:10.1016/s0039-6060(97)90051-9

PMID:9186463

Abstract

BACKGROUND

The clinicopathologic characteristics and prognosis for patients with node-negative gastric cancer have heretofore remained to be determined.

METHODS

We analyzed data on 730 of our patients with node-negative gastric cancer who underwent curative gastric resection in the Department of Surgery II, Kyushu University Hospital, between 1965 and 1990, with reference to prognostic factors. The presence of lymph node metastasis was determined by means of routine hematoxylin-eosin staining of excised tissues.

RESULTS

The 5-year survival rate was 91.7% and the 10-year rate was 88.5%; thus the prognosis was good for patients with node-negative gastric cancer. When the prognosis was analyzed by stratification of each clinicopathologic factor, the survival time was shorter for older patients when the size of the tumor was larger, when the tumor involved the entire stomach, and when-tissues revealed infiltrative growth, serosal invasion, and lymphatic invasion. Extensive lymph node dissection was performed for 86.6% of the patients, and for these patients the prognosis was better, with a statistical difference. In a multivariate analysis, tumor size, serosal invasion, and extensive lymph node dissection proved to be independent prognostic factors for patients with node-negative gastric cancer.

CONCLUSIONS

Prophylactic lymph node dissection for patients with gastric cancer will prolong the survival time.

摘要

背景

迄今为止，淋巴结阴性胃癌患者的临床病理特征及预后仍有待确定。

方法

我们分析了1965年至1990年间在九州大学医院第二外科接受根治性胃切除术的730例淋巴结阴性胃癌患者的数据，并参考了预后因素。通过对切除组织进行常规苏木精-伊红染色来确定是否存在淋巴结转移。

结果

5年生存率为91.7%，10年生存率为88.5%；因此，淋巴结阴性胃癌患者的预后良好。当按各临床病理因素分层分析预后时，年龄较大、肿瘤体积较大、肿瘤累及全胃、组织呈浸润性生长、浆膜侵犯和淋巴侵犯的患者生存时间较短。86.6%的患者接受了广泛的淋巴结清扫，这些患者的预后较好，存在统计学差异。多因素分析显示，肿瘤大小、浆膜侵犯和广泛的淋巴结清扫是淋巴结阴性胃癌患者的独立预后因素。