An evaluation of the effectiveness of extended lymph node dissection in patients with gastric cancer: A retrospective study of 1403 cases at a single institution
An evaluation of the effectiveness of extended lymph node dissection in patients with gastric cancer: A retrospective study of 1403 cases at a single institution
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DOI：
10.1006/jsre.2002.6368
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发表时间：
2002-04-01
影响因子：
2.2
通讯作者：
Takayama, T
中科院分区：
文献类型：
--
作者：
Kasakura, Y;Mochizuki, F;Takayama, T
背景。许多研究人员报告说，扩大淋巴结清扫（132 清扫）可能是一种有效的手术。然而，D2 解剖可提高生存率的理论尚未在随机试验中得到证实。我们试图证实 D2 解剖联合胃切除术治疗胃癌的有效性。材料和方法。胃癌患者（1403 名）通过 D1（991 名患者）或 D2（412 名患者）胃切除术进行根治性切除。比较两组患者的生存率，并根据分期、浸润深度和淋巴结转移进行细分。比较肉眼观察和组织学观察结果对淋巴结转移的诊断。结果。患者总体生存率没有显着差异。然而，在II期、T1或T2或N1期疾病的患者中，D2组的生存率明显好于D1组。 N1组淋巴结转移假阳性率为53.3%，N2组为26.2%，N3组为9.2%。在相当比例的N1和N2患者中，组织学表现比肉眼诊断更多或更少的转移。结论。转移性淋巴结应尽可能切除。对于 T1、N1 或 T2、N1 疾病，特别是年轻患者，建议进行 D2 胃切除术。 (C) 2002 年爱思唯尔科学（美国）。
Background. Many investigators have reported that extended lymph node dissection (132 dissection) is probably an effective procedure. However, the theory that D2 dissection leads to an improvement in survival has not been confirmed in randomized trials. We attempted to confirm the effectiveness of D2 dissection with gastrectomy for gastric cancer.Materials and methods. Gastric cancer patients (1403) underwent curative resection by D1 (991 patients) or D2 (412 patients) dissection with gastrectomy. Survival rates calculated for all patients and subdivided for stage, depth of invasion, and lymph node metastasis were compared between the two groups. The diagnosis of lymph node metastasis was compared between macroscopic and histological findings.Results. There was no significant difference in the survival of patients overall. However, in the patients with stage II, T1 or T2, or N1 disease, the survival of the D2 group was significantly better than that of the D1 group. The false positive rates of lymph node metastasis were 53.3% in the N1 group, 26.2% in the N2 group, and 9.2% in the N3 group. In a considerable proportion of the N1 and N2 patients, histological findings proved more or fewer metastases than macroscopic diagnosis.Conclusions. Metastatic lymph nodes should be resected as far as possible. D2 dissection with gastrectomy is recommended for T1, N1 or T2, N1 disease, particularly in younger patients. (C) 2002 Elsevier Science (USA).