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Stage Ⅳ胃癌切除症例の検討


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Title: Stage Ⅳ胃癌切除症例の検討
Other Titles: Significance of surgical treatment for stage Ⅳ gastric cancer
Authors: 三浦, 敏夫 / 草野, 裕幸 / 宮下, 光世 / 中越, 享 / 清水, 輝久 / 平野, 達雄 / 富田, 正雄 / 浦田, 秀子 / 宮下, 弘子
Authors (alternative): Miura, Toshio / Kusano, Hiroyuki / Miyashita, Kosei / Nakagoe, Tohru / Shimizu, Teruhisa / Hirano, Tatsuo / Tomita, Masao / Urata, Hideko / Miyashita, Hiroko
Issue Date: 31-Mar-1993
Citation: 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1993, 6, p.63-72
Abstract: 過去22年間のStage Ⅳ切除胃癌320例について予後の面より検討を加え以下の結果を得た.胃癌取扱い規約による規定因子は単因子が40.6%を占め,遠隔成績ではS,P,N,Hの順に予後は良好であった.2因子ではSP,SN,HN,PN,SHの順であり,3因子間には差は認めなかった.断端遺残を加えた非治癒因子数では,1個のもの(35.3%)は2個以上のものに比べ有意に良好であった.治癒切除は7.8%に行われたが,絶対非治癒243例の平均生存日数は293日で不良であった.切除例では非切除胃癌と比べ有意に良好であった.切除術式では部分切除が不良であったほかには差は認めなかった.以上よりStage Ⅳ胃癌のうち予後不良群として亜分類するとすれば,n4,P2-3,H1-3の各因子をもつものである. / For 320 cases of stage IV gastric cancer operated on at the First Department of Surgery, Nagasaki University during a period of 22 years from 1969 to 1990, the stage IV factors as defined by General Rules for Gastric Cancer stage were divided into groups and late results of operation were mainly studied to obtain results as followed. Cases of stage IV gastric cancer accounted for 30.6% of the cases of gastric cancer subjected to laparotomy and for 23.2% of the cases of gastric cancer treated by resection. By curatice operation, the cases were broken down to absolute cure 11 cases, relative cure 14 cases, relative non-cure 49 cases and absolute non-cure 243 cases. The mean number of days of survival after operation was 1222, 686, 897 and 293 days respectively, there being a significant difference (p<0.005) between the absolute non-cure and relative cure. The prognosis of inoperable stage IV gastric cancer (129 cases) was significantly poor (p<0.0001) compared with stage IV gastric cancer for which resection was done (320 cases). As for the prognosis by the type of operation, there was a significant difference (p<0.0001) among partial resection and total gastrectomy, subtotal gastrectomy, but no difference was found between other types of operation. As for the stage IV factors, cases of single factor accounted for 40.6%. The late result was best in factor S, followed by factor P, factor N and factor H in this order. In the 2 factor cases, the survival period was the longest in SP followed by SN, HN, PN and SH, but no significant difference was found between them except SP>SH (p<0.05), nor was there any significant difference between the 3 factor cases. Regarding the number of non-cure factors with the residue of cut end cancer added, cases with 1 factor accounted for 35.3%, of which late result was significantly better compared with the cases having 2 or more factors. We concluded that it is reasonable that of the cases of stage IV gastric cancer, those of n4, P2-3 and H1-3 be subclassified as IVb.
Keywords: Stage Ⅳ胃癌 / 非治癒切除胃癌 / 非切除胃癌
URI: http://hdl.handle.net/10069/18192
ISSN: 09160841
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 6

Citable URI : http://hdl.handle.net/10069/18192

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