Kikuchi S, Tsukamoto H, Mieno H, Sato K, Kobayashi N, Shimao H, Sakakibara Y, Hiki Y, Kakita A
Department of Surgery, School of Medicine, Kitasato University, Kanagawa, Japan.
Hepatogastroenterology. 1998 Mar-Apr;45(20):592-6.
BACKGROUND/AIMS: The present study was carried out in order to examine the outcome of resection in cases of gastric cancer with distant metastases.
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.
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.
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.
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。
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。
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%。
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。