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伴有远处转移的胃癌切除术的结果

Results of resection of gastric cancer with distant metastases.

作者信息

Kikuchi S, Tsukamoto H, Mieno H, Sato K, Kobayashi N, Shimao H, Sakakibara Y, Hiki Y, Kakita A

机构信息

Department of Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.

出版信息

Hepatogastroenterology. 1998 Mar-Apr;45(20):592-6.

PMID:9638458
Abstract

BACKGROUND/AIMS: The present study was carried out in order to examine the outcome of resection in cases of gastric cancer with distant metastases.

METHODOLOGY

The survival rates of two hundred and eighty-one patients who had undergone resection for primary carcinomas of the stomach, and who had distant metastases according to the TNM classification, were studied.

RESULTS

The 5-year survival rates for patients with metastasis to the peritoneum or group 3 nodes were 8.9% and 15.3% respectively and were significantly higher than the survival rates for patients with metastasis to the liver (0%), to group 4 nodes (2.2%) or to more than one site among the liver, lymph nodes and peritoneum (3.5%). Moreover, the 5-year survival rates for patients with metastasis to the peritoneum and N3 nodes increased significantly to 29.4% and 24.2%, respectively, when curative surgery was performed.

CONCLUSIONS

The findings of the present study suggests that metastases to the adjacent peritoneum or group 3 nodes have a greater chance of being cured using radical surgery, and that gastrectomy with extended lymphadenectomy (D2-D3) may be used for advanced gastric cancer if there is no gross evidence of metastasis to the distant peritoneum, liver or group 4 nodes.

摘要

背景/目的:开展本研究以检查伴有远处转移的胃癌患者的切除结果。

方法

研究了281例因原发性胃癌接受切除且根据TNM分类有远处转移的患者的生存率。

结果

转移至腹膜或3组淋巴结的患者5年生存率分别为8.9%和15.3%,显著高于转移至肝脏(0%)、4组淋巴结(2.2%)或肝脏、淋巴结和腹膜中一个以上部位(3.5%)的患者的生存率。此外,当进行根治性手术时,转移至腹膜和N3淋巴结的患者5年生存率分别显著提高至29.4%和24.2%。

结论

本研究结果表明,对于转移至邻近腹膜或3组淋巴结的患者,根治性手术治愈的机会更大;如果没有远处腹膜、肝脏或4组淋巴结转移的明显证据,扩大淋巴结清扫(D2 - D3)的胃切除术可用于进展期胃癌。

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