胃癌37年临床研究的结果分析——附2326例报告

Thirty-seven-year Clinical Experience on Gastric Cancer-A Report of 2326 Cases

目的：观察胃癌治疗水平的年代性变化，设计各期胃癌合理的治疗方案。方法：以中国医科大学肿瘤研究所３７年２３２６例胃癌手术病例为研究对象，分１９６１～１９７８年，１９７９～１９９７年两个阶段进行分析，观察其手术切除率、根治切除率、根治术后５年生存率的年代性变化。比较各类手术、各种术式的生存曲线，评价其优缺点。结果：胃癌手术切除率由６０年代的５０６％上升到近年的８６４％。根治术后的５年生存率由６０年代的１９６％上升到近年的５７６％。早期胃癌应以Ｄ１＋为基本术式，进行期应以Ｄ３手术疗效最好，贲门癌的全胃切除术优于近端切除术，联合脏器切除可取得较好的术后生存率，胃癌围手术期综合治疗可提高一定疗效。结论：近２０年来，我国胃癌治疗进入一个合理化、规范化阶段，胃癌根治术的５年生存率提高１０％～１５％。

Objective: To review the advancement occurred in the treatment of gastric cancer and to map out the proper approach of plans for the tumor Methods: Comprehensive analysis was made on 2326 operative cases of gastric cancer in Oncology Institute of China Medical University over the past 37 years These cases were divided into two groups according to time periods of 19611977 and 19791997 This study compared the survival curves of each type of surgical operation and evaluated their advantage and disadvantage Results :The rate of gastrectomy grew from 500%in 1960s to 864%to date The 5-year survival rate increased from 190%in 1960s to the current 576% Early gastric cancer should mainly use D1+surgery and the therapeutic effect of D3 operation for advanced gastric cancer was most favorable The therapeutic effect of total gastrectomy in cardiac cancer was better than proximal gastrectomy Associated organs resection resulted in admirable survival The therapeutic effect could be increased by combination ther at perioperative period for gastric cancer Conclusion : Over the last 20 years, therapy of gastric cancer in our country has seen improvement The survival rate of radical gastrectomy increased by 1015%