• 廣西醫(yī)科大學(xué)第一附屬醫(yī)院普外科（南寧530021）;

目的探討提高進(jìn)展期胃癌臨床治療水平的策略。
方法在Medline上檢索有關(guān)文獻(xiàn)并綜述。
結(jié)果第5版UICC/AJCC胃癌TNM分期對評估胃癌擴(kuò)大淋巴結(jié)切除術(shù)的預(yù)后作用有意義。胃癌的分期、淋巴結(jié)切除的范圍、程度及輔助性治療方案等都是影響胃癌預(yù)后的因素。
結(jié)論對胃癌根治術(shù)的病例應(yīng)實(shí)施個(gè)體化擴(kuò)大淋巴結(jié)切除術(shù)和堅(jiān)持綜合性治療原則。

引用本文： 解乃昌,林進(jìn)令. 進(jìn)展期胃癌臨床治療的現(xiàn)狀. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(1): 52-55. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. Ichikura T, Ogawa T, Chochi K, et al. Minimum number of lymph nodes that should be examined for the International Union Against Cancer/American Joint Committee on Cancer TNM classification of gastric carcinoma [J]. World J Surg, 2003; 27(3)∶330.
2. Kikuchi S, Katada N, Sakuramoto S, et al. Factors associated with pN3 stage tumors according to the TNM classification in advanced gastric cancer [J]. Hepatogastroenterology, 2003; 50(53)∶1723.
3. Nitti D, Marchet A, Olivieri M, et al. Lymphadenectomy in patients with gastric cancer. A critical review [J]. Suppl Tumori, 2003; 2(5)∶S35.
4. Roviello F, Marrelli D, Morgagni P, et al. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: a longitudinal multicenter study [J]. Ann Surg Oncol, 2002; 9(9)∶894.
5. Edwards P, Blackshaw GR, Lewis WG, et al. Prospective comparison of D1 vs modified D2 gastrectomy for carcinoma [J]. Br J Cancer, 2004; 90(10)∶1888.
6. Verreet PR. Stageadapted radical principles in gastric carcinoma [J]. Schweiz Rundsch Med Prax, 1998; 87(13)∶447.
7. Roviello F, Marrelli D, Morgagni P, et al. Benefits of extended lymphadenectomy in patients with gastric carcinoma with metastasis to second level lymph nodes. An Italian multicenter study [J]. Chir Ital, 2003; 55(4)∶491.
8. Ikeguchi M, Oka S, Gomyo Y, et al. Prognostic benefit of extended radical lymphadenectomy for patients with gastric cancer [J]. Anticancer Res, 2000; 20(2B)∶1285.
9. Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial [J]. J Clin Oncol, 2004; 22(11)∶2069.
10. Maruyama K, Sasako M, Kinoshita T, et al. Reasonable lymph node dissection in radical gastrectomy for gastric cancer: introduction of computer information system and lymphography technique by Indiaink [J]. Nippon Geka Gakkai Zasshi, 1989; 90(9)∶1318.
11. Maruyama K, Gunven P, Okabayashi K, et al. Lymph node metastases of gastric cancer. General pattern in 1 931 patients [J]. Ann Surg, 1989; 210(5)∶596.
12. Omejc M, Mekicar J. Role of computer analysis in gastric cancer surgery: evaluation of the WinEstimate v. 2.5 computer program [J]. World J Surg, 2004; 28(1)∶59.
13. Ohta K, Nishi M, Nakajima T, et al. Indications for total gastrectomy combined with pancreaticosplenectomy in the treatment of middle gastric cancer [J]. Nippon Geka Gakkai Zasshi, 1989; 90(9)∶1326.
14. Kikuchi S, Nemoto Y, Natsuya K, et al. Which patients with advanced, proximal gastric cancer benefit from complete clearance of splenopancreatic lymph nodes? [J]. Anticancer Res, 2002; 22(6B)∶3513.
15. Marrelli D, Roviello F, de Manzoni G, et al. Different patterns of recurrence in gastric cancer depending on Lauren’s histological type: longitudinal study [J]. World J Surg, 2002; 26(9)∶1160.
16. Shiraishi N, Inomata M, Osawa N, et al. Early and late recurrence after gastrectomy for gastric carcinoma. Univariate and multivariate analyses [J]. Cancer, 2000; 89(2)∶255.
17. Funami Y, Tokumoto N, Miyauchi H, et al. Prognostic value of peritoneal lavage cytology and chemotherapy during surgery for advanced gastric cancer [J]. Int Surg, 1999; 84(3)∶220.
18. Sethna KS, Sugarbaker PH. New prospects for the control of peritoneal surface dissemination of gastric cancer using perioperative intraperitoneal chemotherapy [J]. Cancer Therapy, 2004; 2（A）∶79.
19. Marutsuka T, Shimada S, Shiomori K, et al. Mechanisms of peritoneal metastasis after operation for nonserosainvasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis [J]. Clin Cancer Res, 2003; 9(2)∶678.
20. Yonemura Y, de Aretxabala X, Fujimura T, et al. Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomized controlled study [J]. Hepatogastroenterology, 2001; 48(42)∶1776.
21. 梁寒， 王仆， 王曉娜， 等. 活性碳吸附絲裂霉素C腹腔化療預(yù)防進(jìn)展期胃癌術(shù)后復(fù)發(fā) [J]. 中華外科雜志, 2003; 41(4)∶274.
22. Newman E, Marcus SG, Potmesil M, et al. Neoadjuvant chemotherapy with CPT11 and cisplatin downstages locally advanced gastric cancer [J]. J Gastrointest Surg， 2002; 6(2)∶212.
23. Ajani JA, Mansfield PF, Janjan N, et al. Multiinstitutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma [J]. J Clin Oncol， 2004; 22(14)∶2774.
24. Kim JP, Yu HJ, Lee JH. Results of immunochemosurgery for gastric carcinoma [J]. Hepatogastroenterology， 2001; 48(41)∶1227.
25. Nakahara S, Tsunoda T, Baba T, et al. Dendritic cells stimulated with a bacterial product, OK432, efficiently induce cytotoxic T lymphocytes specific to tumor rejection peptide [J]. Cancer Res， 2003; 63(14)∶4112.
26. Kono K, Takahashi A, Ichihara F, et al. Prognostic significance of adoptive immunotherapy with tumorassociated lymphocytes in patients with advanced gastric cancer: a randomized trial [J]. Clin Cancer Res， 2002; 8(6)∶1767.
27. Kono K, Takahashi A, Sugai H, et al. Dendritic cells pulsed with HER2/neuderived peptides can induce specific Tcell responses in patients with gastric cancer [J]. Clin Cancer Res， 2002; 8(11)∶3394.
  1. 1. Ichikura T, Ogawa T, Chochi K, et al. Minimum number of lymph nodes that should be examined for the International Union Against Cancer/American Joint Committee on Cancer TNM classification of gastric carcinoma [J]. World J Surg, 2003; 27(3)∶330.
  2. 2. Kikuchi S, Katada N, Sakuramoto S, et al. Factors associated with pN3 stage tumors according to the TNM classification in advanced gastric cancer [J]. Hepatogastroenterology, 2003; 50(53)∶1723.
  3. 3. Nitti D, Marchet A, Olivieri M, et al. Lymphadenectomy in patients with gastric cancer. A critical review [J]. Suppl Tumori, 2003; 2(5)∶S35.
  4. 4. Roviello F, Marrelli D, Morgagni P, et al. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: a longitudinal multicenter study [J]. Ann Surg Oncol, 2002; 9(9)∶894.
  5. 5. Edwards P, Blackshaw GR, Lewis WG, et al. Prospective comparison of D1 vs modified D2 gastrectomy for carcinoma [J]. Br J Cancer, 2004; 90(10)∶1888.
  6. 6. Verreet PR. Stageadapted radical principles in gastric carcinoma [J]. Schweiz Rundsch Med Prax, 1998; 87(13)∶447.
  7. 7. Roviello F, Marrelli D, Morgagni P, et al. Benefits of extended lymphadenectomy in patients with gastric carcinoma with metastasis to second level lymph nodes. An Italian multicenter study [J]. Chir Ital, 2003; 55(4)∶491.
  8. 8. Ikeguchi M, Oka S, Gomyo Y, et al. Prognostic benefit of extended radical lymphadenectomy for patients with gastric cancer [J]. Anticancer Res, 2000; 20(2B)∶1285.
  9. 9. Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial [J]. J Clin Oncol, 2004; 22(11)∶2069.
  10. 10. Maruyama K, Sasako M, Kinoshita T, et al. Reasonable lymph node dissection in radical gastrectomy for gastric cancer: introduction of computer information system and lymphography technique by Indiaink [J]. Nippon Geka Gakkai Zasshi, 1989; 90(9)∶1318.
  11. 11. Maruyama K, Gunven P, Okabayashi K, et al. Lymph node metastases of gastric cancer. General pattern in 1 931 patients [J]. Ann Surg, 1989; 210(5)∶596.
  12. 12. Omejc M, Mekicar J. Role of computer analysis in gastric cancer surgery: evaluation of the WinEstimate v. 2.5 computer program [J]. World J Surg, 2004; 28(1)∶59.
  13. 13. Ohta K, Nishi M, Nakajima T, et al. Indications for total gastrectomy combined with pancreaticosplenectomy in the treatment of middle gastric cancer [J]. Nippon Geka Gakkai Zasshi, 1989; 90(9)∶1326.
  14. 14. Kikuchi S, Nemoto Y, Natsuya K, et al. Which patients with advanced, proximal gastric cancer benefit from complete clearance of splenopancreatic lymph nodes? [J]. Anticancer Res, 2002; 22(6B)∶3513.
  15. 15. Marrelli D, Roviello F, de Manzoni G, et al. Different patterns of recurrence in gastric cancer depending on Lauren’s histological type: longitudinal study [J]. World J Surg, 2002; 26(9)∶1160.
  16. 16. Shiraishi N, Inomata M, Osawa N, et al. Early and late recurrence after gastrectomy for gastric carcinoma. Univariate and multivariate analyses [J]. Cancer, 2000; 89(2)∶255.
  17. 17. Funami Y, Tokumoto N, Miyauchi H, et al. Prognostic value of peritoneal lavage cytology and chemotherapy during surgery for advanced gastric cancer [J]. Int Surg, 1999; 84(3)∶220.
  18. 18. Sethna KS, Sugarbaker PH. New prospects for the control of peritoneal surface dissemination of gastric cancer using perioperative intraperitoneal chemotherapy [J]. Cancer Therapy, 2004; 2（A）∶79.
  19. 19. Marutsuka T, Shimada S, Shiomori K, et al. Mechanisms of peritoneal metastasis after operation for nonserosainvasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis [J]. Clin Cancer Res, 2003; 9(2)∶678.
  20. 20. Yonemura Y, de Aretxabala X, Fujimura T, et al. Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomized controlled study [J]. Hepatogastroenterology, 2001; 48(42)∶1776.
  21. 21. 梁寒， 王仆， 王曉娜， 等. 活性碳吸附絲裂霉素C腹腔化療預(yù)防進(jìn)展期胃癌術(shù)后復(fù)發(fā) [J]. 中華外科雜志, 2003; 41(4)∶274.
  22. 22. Newman E, Marcus SG, Potmesil M, et al. Neoadjuvant chemotherapy with CPT11 and cisplatin downstages locally advanced gastric cancer [J]. J Gastrointest Surg， 2002; 6(2)∶212.
  23. 23. Ajani JA, Mansfield PF, Janjan N, et al. Multiinstitutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma [J]. J Clin Oncol， 2004; 22(14)∶2774.
  24. 24. Kim JP, Yu HJ, Lee JH. Results of immunochemosurgery for gastric carcinoma [J]. Hepatogastroenterology， 2001; 48(41)∶1227.
  25. 25. Nakahara S, Tsunoda T, Baba T, et al. Dendritic cells stimulated with a bacterial product, OK432, efficiently induce cytotoxic T lymphocytes specific to tumor rejection peptide [J]. Cancer Res， 2003; 63(14)∶4112.
  26. 26. Kono K, Takahashi A, Ichihara F, et al. Prognostic significance of adoptive immunotherapy with tumorassociated lymphocytes in patients with advanced gastric cancer: a randomized trial [J]. Clin Cancer Res， 2002; 8(6)∶1767.
  27. 27. Kono K, Takahashi A, Sugai H, et al. Dendritic cells pulsed with HER2/neuderived peptides can induce specific Tcell responses in patients with gastric cancer [J]. Clin Cancer Res， 2002; 8(11)∶3394.