[Surgical treatment and prognosis of stomach carcinoma with special reference to gastrectomy as a standard operation].
Data on 25 early and 227 advanced gastric cancer patients treated surgically in our clinic over an eight-year period from 1979 to 1986 have been analyzed retrospectively. In 45.5% (n = 110) curative resection and in 27.3% (n = 66) palliative resection was performed. In another 27.3% (n = 66) only a non-resecting procedure was possible. The overall hospital mortality was 10.7% (26/242). It was 9.1% (16/176) after resection and 15% (10/66) after non-resecting procedures. Total gastrectomy "de principe" with compartment II lymphadenectomy was performed in 70.5% (124/176). Total hospital mortality was 8.9% (n = 11) and leakage of the proximal anastomosis was observed in 8.1% (n = 10). Hospital mortality of the remaining resected patients was 3.2% (1/31) after distal resection, 20% (3/15) after proximal resection and 16.7% (1/6) after total esophagogastrectomy with colon interposition. All patients were staged according to UICC classification and staging was I 8.5%, II 14%, III 23% and IV 54.5%. Actuarial 5-year survival in all patients surviving resection was depending on stage of disease at operation (stage I 100%, II 53.3%, III 29% and IV 0%). It differed most significantly (p less than 0.001) for curative (49%) and palliative resections (0%). These results indicate that improvement of results requires early diagnosis with immediate surgical intervention.
Roukos
D
D
Zentrum der Chirurgie, Klinikum der J. W. Goethe-Universität, Frankfurt.
Lorenz
M
M
Hottenrott
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
Operative Behandlung und Prognose des Magenkarzinoms unter besonderer Berücksichtigung der Gastrektomie als Regeloperation.