Extended surgical resection in T4 gastric cancer
Extended surgical resection in T4 gastric cancer
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DOI：
10.1016/s0002-9610(97)00268-7
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发表时间：
1998-02-01
影响因子：
3
通讯作者：
Evans, SRT
中科院分区：
文献类型：
--
作者：
Shchepotin, IB;Chorny, VA;Evans, SRT
背景技术背景：一些医生仍然认为胃癌侵犯邻近器官是不可治愈的疾病的征兆。方法：回顾性分析了353例T-4胃癌患者行联合胃切除术的情况。237例（67.1%）患者行胃大部切除术，116例（32.9%）患者行全胃切除术。最常与胃一起切除的器官为横结肠159例（45%），胰尾和脾150例（42.5%），肝左叶101例（28.5%），胰头37例（10.5%）。在该患者亚组中共发生110例术后并发症，并发症发生率为31.2%。该患者亚组中共发生48例术后死亡，死亡率为13.6%。所有接受联合胃切除术的患者的5年生存率为25%。淋巴结阴性的T-4胃癌切除术，37%存活5年，而T-4淋巴结阳性切除术只有15%5-year survival.CONCLUSIONS：T-4胃癌患者（约20%的患者）将受益于积极的块手术切除术，不应被视为不可切除。(C)1998年，Excerpta Medica，Inc.
BACKGROUND: Some physicians still consider invasion of adjacent organs by the carcinoma of stomach as a sign of incurable disease.METHODS: This retrospective study has been done with particular reference to 353 T-4 gastric cancer patients who underwent combined gastrectomies with adjacent organs.RESULTS: Subtotal gastrectomy was performed in 237 (67.1%) patients and total gastrectomy was performed in 116 (32.9%) patients. Organs most commonly resected with the stomach were the transverse colon in 159 (45%) cases, the tail of pancreas and spleen in 150 (42.5%), the left lobe of liver in 101 (28.5%), and the head of pancreas in 37 (10.5%) patients. A total of 110 postoperative complications occurred in this subset of patients corresponding to a complication rate of 31.2%. A total of 48 postoperative deaths occurred in this subset of patients corresponding to a mortality rate of 13.6%. The 5-year survival rate for all patients who underwent combined gastrectomy with adjacent organs was 25%. Of the node-negative T-4 gastric cancer resections, 37% survived 5 years whereas the T-4 node-positive resections have only a 15% 5-year survival.CONCLUSIONS: Patients who present with T-4 gastric cancer (about 20% of the patient population) will benefit from aggressive on bloc surgical resection and should not be considered unresectable. (C) 1998 by Excerpta Medica, Inc.