Uesaka K, Nimura Y, Kamiya J, Nagino M, Kanai M, Yuasa N
First Dept. of Surgery, Nagoya University School of Medicine, Japan.
Gan To Kagaku Ryoho. 1998 Jul;25(8):1131-6.
Differences in surgical strategies for carcinoma of the pancreas, especially the head of the pancreas, between Japan and western countries are described. In Japan, pancreatoduodenectomy (PD) or pylorus-preserving PD, accompanied by extensive lymph node and extra-pancreatic nerve plexus dissection, is performed for this difficult disease. Combined resection of the portal vein is also done when needed (radical resection). In western countries, a standard PD does not include extensive lymph node dissection and portal vein resection (standard resection). Although some Japanese surgeons reported about 30% postoperative 5-year survival rates after radical resection and some American surgeons achieved about 20% 5-year survival rates after standard resection, there are some problems with comparison of these results. Surgeons in Japan and western countries use different staging systems, namely, the classifications of the Japanese Pancreas Society and the Union of Internationale Contre le Cancer (UICC). It is essential to establish a more accurate international staging system to scientifically evaluate the difference in surgical results between Japan and western countries.
本文描述了日本与西方国家在胰腺癌，尤其是胰头癌手术策略上的差异。在日本，针对这种疑难疾病会施行胰十二指肠切除术（PD）或保留幽门的PD，并伴有广泛的淋巴结清扫和胰腺外神经丛剥离。必要时还会进行门静脉联合切除（根治性切除）。在西方国家，标准的PD不包括广泛的淋巴结清扫和门静脉切除（标准切除）。尽管一些日本外科医生报告称根治性切除术后5年生存率约为30%，一些美国外科医生在标准切除术后实现了约20%的5年生存率，但比较这些结果存在一些问题。日本和西方国家的外科医生使用不同的分期系统，即日本胰腺学会的分类和国际抗癌联盟（UICC）的分类。建立一个更准确的国际分期系统对于科学评估日本和西方国家手术结果的差异至关重要。
