Yılmaz ERSAN, Gülen DOĞUSOY, Ömer UYSAL, Süphan ERTÜRK, Yusuf ÇİÇEK

Tis/T1/T2 evrelerindeki mide karsinomu olgularında küratif rezeksiyon sonuçları

1989-1993 yılları arasında, İstanbul Üniver¬sitesi, Cerrahpaşa Tıp Fakültesi, Genel Cerrahi Anabilim Dalında, primer mide adenokarsino-mu sebebiyle rezeksiyon uygulanan 278 hasta¬dan 50'sinde serozal invazyon bulunmadığını yani TjS/Tı ve T2 evrelerinde bulundukları tes¬pit edildi. Bu retrospektif araştırmada, hatsala-rın en erken 5,5 sene, en geç 8 senelik uzun ev-reli takip sonuçları öğrenildi; ancak 2 hastaya ulaşılamadı. En az, geniş lokal eksizyon (3 olguda), ço¬ğunlukla Distal Gastrektomi (28 olguda) uygu¬lanan hastalarda T-JTı olgularında 5 yıllık sür¬vi %100 iken , T2 tümörlü olgularda 5 yıllık sürvi %68,8'dir. Nüks sebebiyle 5 yıl yaşaya¬mayan T2 evresindeki tümörlü olgularda, lenf nodülü metastazı %91,6 iken, %8,3'de lenf no¬dülü metastazı bulunmadığ tespit edilmiştir. Sonuç olarak serozal invazyon yapmamış, pri¬mer mide karsinomu olgularında, küratif rezek¬siyon sonrası sürviyi etkileyen başlıca faktörün metastatik lenf nodüllerinin mevcudiyeti oldu¬ğu anlaşılmıştır.

Results of curative resection for cases of gastric carcinoma in Tis/T1/T2 stages

Background.- Despite recent improvements in the diagnostic accuracy and techniques for early gastric carcinoma, some patients die of a recurrence, even after resection of an early gastric cancer, (EGC). It has been suggested that patients with T2. No carcinoma of the stomach has a comparable survival rate to patients with T1 carcinoma of the stomach. Study design.- Clinicopathologic features and survival rates of 50 patients with Tis/T1/T2 adenocarcinoma of stomach treated between 1989 to 1993 were reviewed. Prognostic significance of the clinicopathologic features in gastric carcinoma with invasion confined to the stomach wall was studied using both a univariate and a multivariate analysis. Results.- Excluding deaths from causes other than recurrence, five-year survival rate for patients with Tis/T1 carcinoma of stomach was 100 percent. Five-year survival rate for patients with T2 carcinoma of the stomach was 68.8 percent. Conclusions.- In patients with gastric carcinoma with invasion confined to the stomach wall, most important prognostic factor was lymph node invasion.

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