PROGNOSTIC RELEVANCE OF SYSTEMATIC LYMPH-NODE DISSECTION IN GASTRIC-CARCINOMA
PROGNOSTIC RELEVANCE OF SYSTEMATIC LYMPH-NODE DISSECTION IN GASTRIC-CARCINOMA
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DOI：
10.1002/bjs.1800800829
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发表时间：
1993-08-01
影响因子：
9.6
通讯作者：
MEYER, HJ
中科院分区：
文献类型：
--
作者：
SIEWERT, JR;BOTTCHER, K;MEYER, HJ
在一项对 2394 名胃癌患者进行的前瞻性多中心研究中，评估了系统淋巴结清扫术的预后相关性。在 1654 名接受切除的患者中，558 名接受了标准淋巴结清扫，定义为标本中少于 26 个淋巴结，1096 名患者接受了根治性淋巴结切除术，即标本中含有 26 个或更多淋巴结。根治性切除显着提高了国际抗癌联盟 (UICC) H 期和 IIIA 期肿瘤患者的生存率。多变量分析确定根治性解剖是 UICC 肿瘤 H 期和 IIIA 期患者亚组的独立预后因素。根治性切除并不能给 pN2 肿瘤患者带来生存优势。根治性淋巴结清扫术和标准淋巴结清扫术之间的发病率和死亡率没有显着差异。根治性淋巴结切除术可提高 II 期和 IIIA 期 UICC 胃癌患者的生存率，应成为此类患者的推荐治疗方法。
In a prospective multicentre study of 2394 patients with gastric carcinoma the prognostic relevance of systematic lymph node dissection was evaluated. Of 1654 patients undergoing resection, 558 had a standard lymph node dissection, defined as fewer than 26 nodes in the specimen, and 1096 underwent radical lymphadenectomy, i.e. 26 or more nodes in the specimen. Radical dissection significantly improved the survival rate in patients with Union Internacional Contra la Cancrum (UICC) stages H and IIIA tumours. Multivariate analysis identified radical dissection as an independent prognostic factor in the subgroups of patients with UICC tumour stages H and IIIA. Radical dissection conferred no survival advantage in patients with pN2 tumours. There was no significant difference in morbidity and mortality rates between radical and standard lymph node dissection. Radical lymphadenectomy improves survival in patients with UICC gastric cancer stages II and IIIA, and should be the recommended treatment for such patients.