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第57卷 第2期 2024-3
Necrotizing fasciitis resulted from foreign body ingestion and intestinal perforation in an incisional hernia: Report of a case |
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第57卷 第2期 2024-3
Application of artificial intelligence in endodontic microsurgery |
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第57卷 第2期 2024-3
A rare case of cerebral metastasis of malignant peripheral nerve sheath tumor in a patient with neurofibromatosis type 1 |
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第57卷 第2期 2024-3
Ethic in commenting and clinical surgery journal publication: Emerging issue in the era of social media—A story from “Beall” to “Jaime” and independent researcher |
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第57卷 第2期 2024-3
Ophidascaris robertsi, the new emerging human parasite and neurosurgery |
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第57卷 第2期 2024-3
Tetanus toxoid IgG, usefulness in clinical surgery, and diagnostic property limitation |
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第57卷 第2期 2024-3
Deaths among surgeons while on duty: An important issue in surgery and occupational medicine that should not be disregarded |
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第57卷 第2期 2024-3
ChatGPT and its use in clinical surgery: A comment on its pro and con |
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第57卷 第2期 2024-3
Isolated spinal neurocysticercosis and pseudotumor cerebri: Tropical problem to be noted |
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第57卷 第2期 2024-3
Management of massive hemothorax resulting from traumatic diaphragm rupture with kidney avulsion injury by combined anterior thoracoabdominal approaches |
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第57卷 第2期 2024-3
Laparoscopic partial splenectomy for sclerosing angiomatoid nodular transformation: A case report and literature review |
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第57卷 第2期 2024-3
Using three-dimensional versus two-dimensional laparoscopy in sleeve gastrectomy: A case matched comparison |
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第57卷 第2期 2024-3
Effectiveness of placing prophylactic mesh with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer: 1-year results |
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第57卷 第2期 2024-3
Nylon cable ties–assisted delay primary closure of fasciotomy wound in patients of forearm compartment syndrome |
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第57卷 第2期 2024-3
Prefabricated venous fl ap, an advanced free venous fl ap for distant transfer: An experimental rat study |
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第57卷 第1期 2024-1
Isolated lower leg monoplegia due to traumatic intraparenchymal hemorrhage |
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第57卷 第1期 2024-1
Reflections on the association between cholecystectomy, cholelithiasis, and colorectal cancer |
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第57卷 第1期 2024-1
Molluscum contagiosum, false positive, and incidence: Concern in surgery |
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第57卷 第1期 2024-1
New form of COVID-19 vaccine: A new advanced technology for fighting the remained problem |
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第57卷 第1期 2024-1
COVID-19 vaccination, acute appendicitis, interrelationship, and jointed probability: A concern |
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| 篇名 |
Lymph Node Metastasis in Gastric Cancer Indicator or Governor of Survival |
| 作者 |
Chew-Wun Wu |
| 卷期/出版年月 |
41卷4期 (2008/8) |
| 頁次 |
129-134 |
| 摘要 |
To evaluate nodal dissection effect for gastric cancer, eight prospective randomized controlled trials have been reviewed. The first two (Cape Town and Hong Kong) trials were too small to have statistical power. Two large European (Dutch and UK) trials were multi-center trials including learning periods and had difficulty in ensuring quality control. These four trials showed that nodal dissection had a high morbidity and mortality rates but no survival benefit. The Italian trial used pancreas-preserving splenectomy instead of distal pancreatic splenectomy for upper stomach cancer, which decreased morbidity and mortality. The Japanese and Polish trials compared D2 and D3 (D2 plus paraaortic lymph node dissection) resection and showed no difference in morbidity and mortality rates. The Japanese trial did not show survival benefit. We have conducted a single-center trial on advanced gastric cancer, treated by three surgeons, all of whom had received extensive training and had experience of at least 25 D2 resections. Our hospital performs about 80-100 D2 resections per year. Morbidity is higher in D2 patients, which however has not led to mortality. D2 lymph node dissection improves both overall and disease-free survival rates. Taken all these trials together, it seems likely that D2, but not D3 resection, offers a survival benefit, but the procedure should be performed by well-trained, experienced surgeons in hospital for satisfactory results. |
| 關鍵詞 |
nodal dissection,gastric cancer,trial |
| 分類 |
Mini Review |
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