Zusammenfassung
Zwischen dem 1. Januar 1998 und dem 31. Dezember 2002 behandelten wir in der II. Chirurgischen Klinik der Semmelweis-Universität Budapest, Ungarn, 111 Patienten wegen eines Magenkarzinoms. Die Mehrzahl der Patienten wies fortgeschrittene Tumorstadien auf. Bei 65 % aller Fälle konnten wir eine partielle oder totale Gastrektomie vornehmen. War eine R0-Situation möglich, führten wir eine D2-Lymphadenektomie durch, ansonsten eine D1-Lymphadenektomie. Die Rate der postoperativen Komplikationen betrug 15 %, die perioperative Mortalität 5,4 %. 74 Patienten konnten wir nachuntersuchen, von diesen sind 33 noch am Leben, 41 bereits verstorben. Die mittlere Überlebenszeit unserer Patienten beträgt demnach 20,4 Monate (1-58 Monate). Die Überlebenszeit war signifikant kürzer, wenn die Histologie eine Gefäß- oder Lymphbahninfiltration ergab. Dies ist ein Zwischenbericht, die Patienten werden in Zukunft weiter verfolgt.
Abstract
Between the 1st of January, 1998 and the 31st of December, 2002 we treated 111 patients for gastric cancer in the 2nd Department of Surgery, Semmelweis University, Budapest, Hungary. The majority of patients belonged to the advanced stages of the disease. In 65 % of the cases a partial or total gastrectomy was performed. We combined the operation with D2 lymphnode dissection if a R0 resection was possible, in the other cases with D1 lymphadenectomy. Postoperative morbidity rate ranged to 15 %, the mortality 5.4 %. 74 patients could be followed, 41 are dead and 33 still alive. According to the follow up examination the median survival time is 20.4 months at the moment. We observed a significantly shorter survival time, if vascular or lymphoid vessel invasion was present in the histologic specimen. The study has not been finished and the follow up will be continued.
Schlüsselwörter
Magenkarzinom - Morbidität - Überleben - chirurgische Therapie
Key words
Gastric cancer - morbidity - survival - surgical therapy
Literatur
-
1
Bonenkamp J J, Songun I, Hermans J, Sasako M, Welvaart K, Plukker J TM, van Elk P, Obertop H, Oouma D J, Taat C W, van Lanschot J, Meyer S, De Oraaf P W, von Meyenfeldt M F, Tilanus H, van de Velde C JH.
Randomised comparison of morbidity after DI and D2 dissection for gastric cancer in 996 Dutch patients.
Lancet.
1995;
345
745-748
-
2
Bonenkamp J J, Hermans J, Sasako M, van de Velde C JH.
Extended lymph node dissection for gastric cancer.
New Engl J Med.
1999;
340
914-980
-
3
Cuschieri A, Fayers P, Fielding J, Craven J, Bancewicz J, Joypaul V, Cook P.
Postoperative morbidity and mortality after DI and D2 resection for gastric cancer: preliminary result of the MRC randomised controlled surgical trial.
Lancet.
1996;
347
995-999
-
4
Cuschieri A, Weeden S, Fielding J, Bancewicz J, Craven J, Joypaul V, Sydes M, Fayers P.
Patients survival after DI and D2 resection for gastric cancer: long-term results of the MRC randomised surgical trial.
Br J Cancer.
1999;
79
1522-1530
-
5
Horvath Ö P, Kalmar K, Cseke L, Potó L, Zambó K.
Nutritional and life-quality consequences of aboral pouch construction after total gastrectomy: a randomised controlled study.
EJSO.
2001;
27
558-563
-
6
Kitamura K, Nishida S, Ischikawa D, Taniguchi H, Hagiwara A, Yamaguchi T, Sawai K.
No survival benefit from combined pancreatocosplenectomy and total gastrectomy for gastric cancer.
Br J Surg.
1999;
86
119-122
-
7
Pacelli F, Doglietto O B, Bellantone R, Alfieri S, Sgadari A, Crucitti F.
Extensive versus limited lymph node dissection for gastric cancer: a comparative study of 320 patients.
Br J Surg.
1993;
80
1153-1156
-
8
Sasako M.
Risk factors for surgical treatment in the Dutch gastric cancer trial.
Br J Surg.
1997;
84
1567-1571
-
9
Siewert R, Böttcher K, Stein H J, Roder J D. et al .
Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study.
Ann Surg.
1998;
228
449-461
-
10
Smith J W, Shiu M H, Brennan M F.
Morbidity of radical lymphadenectomy in the curative resection of gastric carcinoma.
Arch Surg.
1991;
126
1469-1473
Dr. P. Ondrejka
2nd Department of Surgery · Semmelweis-University
Üllöi úacut;t 78
1082 Budapest
Hungary
