LYMPHADENECTOMY FOR GASTRIC-CANCER IN CLINICAL-TRIALS - UPDATE
LYMPHADENECTOMY FOR GASTRIC-CANCER IN CLINICAL-TRIALS - UPDATE
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DOI：
10.1007/bf00294718
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发表时间：
1995-07-01
影响因子：
2.6
通讯作者：
STEIN, HJ
中科院分区：
文献类型：
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作者：
RODER, JD;BONENKAMP, JJ;STEIN, HJ
关于扩大淋巴结清扫在胃癌治疗中的价值争论激烈。尽管日本外科医生声称，他们的系列中较高的生存率是由于广泛切除（D2切除），但许多西方权威人士认为，他们的结果仅反映了预后因素的普遍差异，日本和西方分期系统之间的不一致，以及广泛切除时发生的“分期迁移”现象。来自香港和开普敦的两项小型随机前瞻性试验显示，广泛的淋巴结清扫有高发病率的趋势，但没有生存益处。相比之下，最近完成的前瞻性德国胃癌研究表明，D2切除术对II期和IIIa期肿瘤有明显的生存优势，围手术期发病率或死亡率没有增加。因此，仍在进行的随机MRC和荷兰试验的长期结果备受期待。
The controversy over the value of extended lymph node dissection for treatment of gastric cancer is fiercely debated. Whereas Japanese surgeons claim that the superior survival rates in their series are due to extensive resection (D2 resection), many Western authorities believe that their results only reflect differences in the prevalence of prognostic factors, inconsistencies between Japanese and Western staging systems, and the phenomenon of ''stage migration,'' which occurs with extensive resection, Two small randomized prospective trials from Dong Kong and Cape Town showed a tendency toward high morbidity with extensive lymph node dissection but no survival benefit. In contrast, the recently completed prospective German Gastric Carcinoma Study demonstrated a clear survival advantage with D2 resection for tumor stages II and IIIa with no increase in perioperative morbidity or mortality. The long-term results of the still ongoing randomized MRC and Dutch trials are therefore eagerly awaited.