Prognostic significance of lymph node dissection in gastric cancer
Prognostic significance of lymph node dissection in gastric cancer
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DOI：
10.1002/bjs.1800831137
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发表时间：
1996-11-01
影响因子：
9.6
通讯作者：
Cordiano, C
中科院分区：
文献类型：
--
作者：
DeManzoni, G;Verlato, G;Cordiano, C
对1988年1月至1994年6月162例因胃癌行根治性胃切除术的患者的结果进行统计分析，特别关注淋巴结清扫的效果，中位生存期为69.3个月，总体累积5年生存期为69.3个月。率为 50.2%（95% 置信区间 (c.i.) 41.6-58.1）。通过单变量分析，发现年龄、组织学、肿瘤浸润深度、淋巴结受累、转移淋巴结数量和淋巴结清扫类型是与生存时间相关的重要因素。使用 Cox 模型进行的多变量分析以及肿瘤淋巴结转移阶段的分层显示，只有转移淋巴结的数量 (P = 0.04) 和淋巴结切除范围 (P = 0.003) 独立影响生存。对于 D-1 淋巴结切除术，与 D-2 和 D-4 淋巴结切除术相关的相对风险分别为 0.61（95% c.i. 0.34-1.10）和 0.26（95% c.i. 0.12-0.60）。 D-1 夹层患者的 5 年生存率为 28%，D-2 夹层患者的 5 年生存率为 63%，D-4 夹层患者的 5 年生存率为 68%。这些结果表明，扩大淋巴结切除术（D-2），尤其是超扩大淋巴结切除术（D-4）可以提高胃癌患者的生存率。
The results for 162 patients who underwent curative gastrectomy for gastric cancer from January 1988 to June 1994 were analysed statistically with special reference to the effect of lymph node dissection, Median survival was 69.3 months and the overall cumulative 5-year survival. rate was 50.2 (95 per cent confidence interval (c.i.) 41.6-58.1) per cent. By univariate analysis age, histology, depth of tumour invasion, node involvement, number of metastatic lymph nodes and type of lymphadenectomy were found to be significant factors related to survival time. Multivariate analysis with the Cox model and stratified for tumour node metastasis stage revealed that only the number of metastatic nodes (P = 0.04) and the extent of lymphadenectomy (P = 0.003) affected survival independently. With respect to D-1 lymphadenectomy, the relative risk associated with D-2 and D-4 lymphadenectomy was respectively 0.61 (95 per cent c.i. 0.34-1.10) and 0.26 (95 per cent c.i. 0.12-0.60). The 5-year survival rate was 28 per cent for patients who had a D-1 dissection, 63 per cent for those who had D-2 and 68 per cent for those who had D-4. These results suggest that extended lymphadenectomy (D-2) and especially superextended lymphadenectomy (D-4) can improve survival in patients with gastric cancer.