治療成績からみた胃筋原性腫瘍の手術適応と術式

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  • INDICATION FOR SURGICAL TREATMENT AND OPTIMAL OPERATIVE PROCEDURE FOR MYOGENIC TUMORS OF THE STOMACH

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Treatment results and clinicopathological features of 41 myogenic tumors of the stomach resected a_??_ the institution in the past 30 years were analyzed. No difference in survival curves was observed betwee_??_ the patients who underwent distal or proximal gastrectomy and those who underwent wedge resectio_??_ A likely explanation for this was that no lymph node metastasis was observed among the cases investiga_??_ ed. Wedge resection without lymphadenectomy, therefore, is feasible, provided that the tumor be resecte_??_ en bloc without residual disease. Perfect histological separation of benign and malignant tumors by_??_conventional HE staining was not constantly attained for cases of borderline malignancy even wit_??_ well-fixed resected specimens. This denotes that preoperative diagnosis by biopsy specimens could b_??_ even more unreliable, and there is a need to establish certain criteria for selecting an adequate therapeuti_??_ strategy for each lesion through endoscopic findings and imaging studies alone. At the same time_??_ emergence of a novel prognostic factor that reflects the malignant potential of the tumors is eagerly_??_ awaited to replace the conventional histopathological diagnosis of whether the tumor be benign o_??_ malignant.

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