淋巴清扫在胃癌治疗中的意义

Significance of Extensive Lymphadenectomy in Gastric Cancer Surgery

目的 探讨淋巴结清扫术在胃癌手术中的价值。 方法 回顾性分析 485例胃癌切除病例 ,按淋巴结清扫范围分为广泛淋巴清扫组及非广泛淋巴清扫组 ,比较两组间的 5年生存率 ,并用Cox比例风险模型分析影响胃癌手术预后的因素。 结果 总体 5年生存率为 3 7.8% ,行广泛淋巴清扫术、非广泛淋巴清扫术后 5年生存率分别为 43 .3 %和16.4% (P <0 .0 0 1)。多元分析表明淋巴清扫程度是影响预后的一个重要因素。 结论 广泛淋巴清扫术可以提高胃癌手术的 5年生存率 ,因而对胃癌应努力开展广泛性淋巴清扫术。

Objective To investigate the therapeutic value of extensive gastric lymphadenectomy in gastric cancer operation. Methods From 485 gastric cancer patients who underwent gastrectomy, extensive lymphadenectomy was performed in 341 patients. The 5 year survival rate of the patients who underwent extensive lymphadenectomy was compared with that of patients who didn't undergo extensive lymphadenectomy. Survival was estimated by the Life Table method and the difference in survival was tested by Wilcoxon (Gehan) test. Multivariate analysis was done by the Cox proportional hazard model. Results The overall 5-year survival rate was 37.8%. The 5-year survival rates for patients undergoing extensive and regular lymphadenectomy were 43.3% and 16.4% respectively ( P < 0.001). Multivariate analysis also showed that extensive lymphadenectomy was an important independent prognostic factor. Conclusions The results indicate that extensive lymphadenectomy can provide a survival benefit for patients with gastric cancer.