Significance of Para-aortic Lymph Node Dissection in Relation to Mean Tumor Diameter of Gastric Carcinoma and Outcome.
|
Accession number;03A0117060
|
| Title;Significance of Para-aortic Lymph Node Dissection in Relation to Mean Tumor Diameter of Gastric Carcinoma and Outcome. |
| Author;
TAKAHASHI SHIGERU
(Shizuokaganse Igeka)
IKAWA OSAMU
(Kyoto Secondo Red Cross Hosp.)
MATSUMURA HIROOMI
(Kyoto Secondo Red Cross Hosp.)
MIYATA KEIGO
(Kyoto Secondo Red Cross Hosp.)
FUJII KOJI
(Kyoto Secondo Red Cross Hosp.)
TAKENAKA ATSUSHI
(Kyoto Secondo Red Cross Hosp.)
|
Journal Title;Journal of Japan Surgical Association
|
Journal Code:Z0103A
|
ISSN:1345-2843
|
|
VOL.64;NO.1;PAGE.5-10(2003)
|
| Figure&Table&Reference;FIG.11, REF.10 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Objective: We evaluated depth of invasion, lymph node metastasis status, and outcome according to mean tumor diameter in freshly resected specimens, and assessed whether tumor diameter can be used as an index for dissection. Subjects and Methods: The diameter of the tumor in freshly resected specimen from 899 patients with primary gastric carcinoma treated by radical dissection at Kyoto Second Red Cross Hospital was measured, and the tumors were classified according to size in one-centimeter increments. Outcome was evaluated according to extent of dissection from Dl to D3 and the presence of lymph node metastatis was examined, chiefly according to mean tumor diameter, measured from the inside of the lumen, and depth of invasion. We then attempted to determine the relation between mean tumor diameter and the optimal extent of dissection. Results: (1) Early gastric carcinoma (EGC) was diagnosed in all cases in which the tumor was less than one centimeter in diameter and in 85% of the cases in which the tumor was 1-2 cm in diameter. The incidence rate of advanced cancer increased with each additional centimeter of tumor size and was 34% in the 2-3 cm group, 50% in the 3-4 cm group, 67% in the 4-5 cm group, and over 80% in the 5 cm and over group. (2) Comparison of outcome according to type dissection showed no significant differences in malignant gastric tumors less than 3 cm in diameter. However, the outcome after Dl dissection was significantly poorer in stage t2 advanced cancer or more advanced cancer. The outcome after D3 dissection was favorable in advanced gastric carcinomas 4-5 cm in diameter, and D3 dissection was followed by a significantly more favorable result in the 5-8 cm group. Comparisons showed no differences according to dissection type in the more than 8 cm group, and obvious cancerous peritonitis accounted for 22.5% of the recurrences.... (author abst.) |
|
|
|
Related Articles;
|
|
|
