Pattern of Lymph Node Involvement in Proximal Gastric Cancer
Pattern of Lymph Node Involvement in Proximal Gastric Cancer
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DOI：
10.1007/s00268-009-0083-6
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发表时间：
2009-08-01
影响因子：
2.6
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Ishikawa, Shinji;Shimada, Shinya;Baba, Hideo
背景胃近端癌的手术方式因机构不同而异，目前尚无最佳的治疗策略。近端胃癌D2手术需行脾门淋巴结（No.10）清扫，即需行脾切除。方法回顾性分析127例近端胃癌患者的临床资料。此外，从文献中收集了1，569例病例，并将其用作进一步分析的汇总数据。结果40例粘膜下近端胃癌均无N2淋巴结转移，其中10例为非粘膜下近端胃癌，其余均为非粘膜下近端胃癌。全组5年生存率为25.2%，无瘤生存率为23.6%。从汇总数据分析，在0.9%的粘膜下近端胃癌患者中观察到10号淋巴结转移。此外，没有第4天的淋巴结转移时，癌的深度是有限的，在浆膜下。结论虽然一个随机对照试验的生存是必要的，根据这项研究。近端胃癌根据胃壁浸润深度的不同，有可能接受有限切除。
Background The operative methods for proximal gastric cancer differ depending oil the institution, thus there is no optimal therapeutic strategy. A splenic hilum lymph node (No. 10) dissection is necessary for D2 operation for proximal gastric cancer, which means it requires splenectomy. However, unnecessary splenectomy should be avoided.Methods A total of 127 proximal gastric cancer cases from Our institution were studied retrospectively. In addition, 1,569 cases were collected from the literature and were used as pooled data for further analysis. All cases were examined for the depth of tumor invasion and lymph node metastasis.Results A retrospective analysis revealed that proximal gastric cancer within submucosa (40 cases) had no N2 lymph node metastasis in our study. The 5-year overall survival of all cases was 25.2% and the disease-free Survival was 23.6%. From the pooled data analysis, No. 10 lymph node metastasis was observed in 0.9% of the patients with submucosa proximal gastric cancer. Furthermore, there was no No. 4d lymph node metastasis when the depth of cancer was limited to within the subserosa.Conclusions Although a randomized, controlled trial concerning Survival is necessary, according to this study. there is a possibility that limited resection might be accepted for proximal gastric cancer according to the depth of wall invasion.