Hanazaki K, Mochizuki Y, Machida T, Yokoyama S, Sodeyama H, Sode Y, Wakabayashi M, Kawamura N, Miyazaki T, Amano J
Department of Surgery, Nagano Red Cross Hospital, Japan.
Hepatogastroenterology. 1998 Jul-Aug;45(22):1159-64.
BACKGROUND/AIMS: The aim of this study is to elucidate significant risk factors of recurrence in muscularis proprial gastric cancer (MPGC).
Seventy-three patients who underwent curative gastrectomy for MPGC were divided into 14 patients with postoperative recurrence (Group 1) and 59 patients without recurrence (Group 2). A retrospective study of Group 1 compared the clinicopathological features with Group 2.
There were no significant differences of age, gender and operative method including frequency of lymph node dissection between Group 1 and Group 2. Although tumor size, gastric location and histological type did not significantly differ between the two groups, the rate of Borrman type in Group 1 (71.4%) was significantly higher than in Group 2 (42.4%). Significant risk factors of recurrence in pathological findings were the presence of secondary lymph node metastasis or more, lymphatic and venous involvement. Median survival in Group 1 (28.8 months) was significantly worse than in Group 2 (59.0 months). The 1-year, 3-year, and 5-year survival rates between Group 1 versus Group 2 were 71.4% versus 98.3% (p<0.01), 28.6% versus 96.7% (p<0.01), and 7. 1% versus 95.0 (p<0.01), respectively.
Prognosis of the postoperative recurrence in MPGC was very poor. More careful prophylactic treatment against recurrence of MPGC should therefore, be prescribed in patients with the aforementioned risk factors of recurrence.
背景/目的：本研究旨在阐明胃固有肌层癌（MPGC）复发的重要危险因素。
73例行MPGC根治性胃切除术的患者被分为14例术后复发患者（第1组）和59例未复发患者（第2组）。对第1组进行回顾性研究，并将其临床病理特征与第2组进行比较。
第1组和第2组在年龄、性别以及包括淋巴结清扫频率在内的手术方式方面无显著差异。尽管两组之间肿瘤大小、胃的位置和组织学类型无显著差异，但第1组的Borrmann分型率（71.4%）显著高于第2组（42.4%）。病理检查中复发的重要危险因素是存在继发性淋巴结转移或更严重的情况、淋巴管和静脉受累。第1组的中位生存期（28.8个月）明显短于第2组（59.0个月）。第1组与第2组的1年、3年和5年生存率分别为71.4%对98.3%（p<0.01）、28.6%对96.7%（p<0.01）和7.1%对95.0%（p<0.01）。
MPGC术后复发的预后非常差。因此，对于具有上述复发危险因素的患者，应给予更谨慎的MPGC复发预防性治疗。
