The Indication of Proximal Gastrectomy and Splenectomy for Proximal Gastric Cancer by the Relationship between the Depth of Cancer Invasion and the Pattern of Lymph Node Metastases

N. Imabayashi
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Abstract

One hundred and twenty-five cases of proximal gastric cancer out of 842 cases of primary gastric cancer seen between 1976 and 1985 were investigated. The incidence of proximal gastric cancer and the incidence of stages I and I have been increasing. Investigation of survival rates indicates the necessity of curative resection of proximal gastric cancer. Proximal gastrectomy could achieve the aim of radical, i. e. , curative treatment, if it is performed in appropriate cases of proximal gastric cancer, that is : 1) carcinoma arising in the proximal third of the stomach without cancer expansion to the middle third of the stomach, 2) superficial cancer limited to submucosa invasion, and 3) no metastasis into lymph nodes along distal portion of stomach. Splenectomy was thought to be unnecessary for curative surgery in patients with superficial cancer.
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胃癌近端胃、脾切除术的适应证:肿瘤浸润深度与淋巴结转移方式的关系
本文对1976年至1985年间842例原发性胃癌中的125例近端胃癌进行了调查。近端胃癌的发病率以及I期和I期的发病率一直在增加。生存率的调查表明胃癌近端根治性切除的必要性。胃近端切除术可以达到根治性即治愈性治疗的目的,如果在适当的近端胃癌病例中进行,即:1)癌发生于胃近端三分之一,癌未扩散至胃中三分之一,2)浅表癌局限于粘膜下层浸润,3)沿胃远端未转移至淋巴结。对于浅表癌患者的根治性手术,脾切除术被认为是不必要的。
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