Naganuma T, Isaji S, Kawarada Y
First Department of Surgery, Mie University School of Medicine, Tsu, Japan.
Pancreas. 1998 Apr;16(3):355-62. doi: 10.1097/00006676-199804000-00024.
Extended surgery is being widely performed to treat pancreatic cancer in Japan, but it has not been evaluated in the same way as in other countries. We, therefore, compared the Japanese Stage Classification (JPN-SC) with the Union Internationale Contre le Cancer Stage Classification (UICC-SC) in the surgical cases of pancreatic cancer treated in our department and then assessed the results of extended resection and associated problems. Problems existed in the resection rates and actuarial survival rates in stages II and III in the UICC-SC, and the JPN-SC was found to reflect more accurately the outcome. On the other hand, although improvements in curative resection and actuarial survival rate have been achieved as a result of extended resection in Japan, the outcome in JPN-SC surgical stage IVb and highly advanced cases in which these resections proved to be noncurative even though they were classified as surgical stage IVa was extremely poor. In the future, it will be necessary to decide on a single-stage classification that is accepted throughout the world and to conduct prospective studies matched to the degree of tumor progression.
在日本，扩大手术被广泛用于治疗胰腺癌，但尚未像其他国家那样进行评估。因此，我们将日本分期分类（JPN-SC）与国际抗癌联盟分期分类（UICC-SC）在我科治疗的胰腺癌手术病例中进行了比较，然后评估了扩大切除的结果及相关问题。UICC-SC中II期和III期的切除率和精算生存率存在问题，发现JPN-SC能更准确地反映结果。另一方面，尽管在日本扩大切除已使根治性切除率和精算生存率有所提高，但JPN-SC手术IVb期以及那些虽被归类为手术IVa期但扩大切除后证实为非根治性的高度进展期病例的结果极差。未来，有必要确定一种全世界都认可的单一分期分类，并开展与肿瘤进展程度相匹配的前瞻性研究。
