Appropriate gastric resection with lymph node dissection for early gastric cancer

被引:39
作者
Borie, F
Plaisant, N
Millat, B
Hay, JM
Fagniez, PL
机构
[1] Hop St Eloi, Serv Chirurgie Digest A, F-34295 Montpellier, France
[2] Hop Louis Mourier, Serv Chirurgie Digest & Gen, Colombes, France
[3] Hop Henri Mondor, Serv Chirurgie Digest & Gen, Creteil, France
关键词
early gastric cancer; lymph node; surgery;
D O I
10.1245/ASO.2004.06.025
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The extent of lymphadenectomy (limited vs. extended) and that of gastric resection (partial vs. total) remain controversial issues in the management of early gastric cancer (EGC). A multicentric study was performed to elucidate the appropriate gastric resection with lymph node dissection for early gastric cancer. Methods: From 1979 to 1988, 332 patients with EGC underwent surgery in 23 French centers. Clinicopathological data, the extent of resection, and the number of lymph nodes retrieved were reviewed retrospectively and screened for prognostic effect. The mean follow-up for the 332 EGC patients was 80 months. Results: Postoperative mortality was correlated to age (odds ratio [OR], 1.1) and extent of gastric resection (OR, 10.3). Examination of survival data (excluding postoperative deaths) with univariate analysis and the Cox proportional hazards model showed that the independent factors for excellent prognosis included no lymphatic involvement (P = .005), 10 or more lymph nodes retrieved (P = .003), site of the tumor in the lower third of the stomach (P = .01), and mucosal lesions (P = .04). The extent of resection did not influence long-term survival. Conclusions: Our results suggest that because of the associated good prognosis, the appropriate surgical treatment for EGC is partial gastrectomy with lymphadenectomy retrieving 10 or more lymph nodes.
引用
收藏
页码:512 / 517
页数:6
相关论文
共 25 条
[1]  
Adachi Y, 1996, CANCER, V77, P2445, DOI 10.1002/(SICI)1097-0142(19960615)77:12<2445::AID-CNCR5>3.0.CO
[2]  
2-L
[3]  
BEHRNS KE, 1992, SURG CLIN N AM, V72, P433
[4]   Extended lymph-node dissection for gastric cancer [J].
Bonenkamp, JJ ;
Hermans, J ;
Sasako, M ;
van de Velde, CJH .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (12) :908-914
[5]   Postoperative morbidity and mortality after D-1 and D-2 resections for gastric cancer: Preliminary results of the MRC randomised controlled surgical trial [J].
Cuschieri, A ;
Fayers, P ;
Fielding, J ;
Craven, J ;
Bancewicz, J ;
Joypaul, V ;
Cook, P .
LANCET, 1996, 347 (9007) :995-999
[6]   RANDOMIZED COMPARISON OF R1 AND R2-GASTRECTOMY FOR GASTRIC-CARCINOMA [J].
DENT, DM ;
MADDEN, MV ;
PRICE, SK .
BRITISH JOURNAL OF SURGERY, 1988, 75 (02) :110-112
[7]   TOTAL VERSUS SUBTOTAL GASTRECTOMY FOR ADENOCARCINOMA OF THE GASTRIC ANTRUM - A FRENCH PROSPECTIVE CONTROLLED-STUDY [J].
GOUZI, JL ;
HUGUIER, M ;
FAGNIEZ, PL ;
LAUNOIS, B ;
FLAMANT, Y ;
LACAINE, F ;
PAQUET, JC ;
HAY, JM .
ANNALS OF SURGERY, 1989, 209 (02) :162-166
[8]  
HABU H, 1986, INT SURG, V71, P244
[9]  
*JAP RES SOC GAST, 1991, JPN J SURG, V11, P140
[10]  
KAJITANI T, 1981, JPN J SURG, V11, P127