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自1958年1月至1987年12月,我院外科共收治胃癌2722例,其中手术2412例(手术率88.6%),切除1720例(切除率71.3%).切除者术后总5年生存率为34.8%.Ⅰa、Ⅰb、Ⅱ、Ⅲa、Ⅲb及Ⅳ期胃癌切除者术后5年生存率分别为98.7%、80.2%、65.7%、44.8%、23.1%及10.8%.随病期趋晚,生存率逐步降低,且各期间差异显著,说明国际胃癌TNM分期法能较好地体现分期与预后理应具备的一致性.若将全组分两个阶段进行分析,则近期组(1984～1987年)5年生存率为41.4%.既往组(1958～1983年)为32.6%.分析还显示5年生存率的提高主要为早、中期病例相对增多所致, 说明早期诊治是提高胃癌生存率的关键.近期组根治性切除术后5年生存率已达61.2%.比较不同根治切除范围(D_1、D_2及D_3术)对各期胃癌的疗效,提示应根据癌肿的部位、分期及生物学特性来制定每一胃癌病例的具体手术方案.
From January 1958 to December 1987, 2722 cases of gastric cancer were treated by surgery in our hospital, including 2412 cases (88.6%) and 1,720 cases (resection rate 71.3%). The total 5-year survival rate of resection was 5 years. The 5-year survival rates of 34.8%, Ia, Ib, II, IIIa, IIIb, and IV resection of gastric cancer were 98.7%, 80.2%, 65.7%, 44.8%, 23.1%, and 10.8%, respectively. The survival rate gradually decreased, and there was a significant difference between periods, indicating that the international TNM staging of gastric cancer can better reflect the consistency of staging and prognosis. If the two-stage analysis of all components, the recent group (1984-1987) The 5-year survival rate was 41.4%. The previous group (1958-1983) was 32.6%. The analysis also showed that the 5-year survival rate increase was mainly due to the relative increase of early-middle-stage cases, indicating that early diagnosis and treatment is to improve the survival rate of gastric cancer. The key point. The 5-year survival rate after radical resection in the recent group has reached 61.2%. The curative effect of different radical resection ranges (D_1, D_2, and D_3) on each stage of gastric cancer suggests that it should be based on the location, stage, and biology of the cancer. Study characteristics to formulate specific surgical plans for each case of gastric cancer.