術におけるリンパ節郭清・神経叢郭清の程度や臓器
温存の程度も、20年前と現在では大きく変化してい
１． Ando N１, Kato H, Igaki H, et al. : A randomized
る。例えば膵癌取扱い規約は第７版（2016）
（4）で大き
trial comparing postoperative adjuvant chemotherapy
with cisplatin and 5-fluorouracil versus preoperative
くStagingも変化し、また最近数年間で術前化学療法
chemotherapy for localized advanced squamous cell
の意義が強く認識され、集学的治療が行われるのが一
carcinoma of the thoracic esophagus（JCOG9907）
. Ann
般化した。したがってある疾患の、ある年代の特定の
治療を行った術後生存曲線の報告と今回の検討を細か
く比較していくのには無理が生じる可能性がある。こ
れは今回の報告が20年の術後成績を包括してまとめた
ものであることが孕んでいるLIMITATIONでもある。
逆にこのような長期の成績を一定の見方でまとめたこ
とに意味があるとも言える。
Surg Oncol. 2012 Jan; 19: 68-74
２． 大腸癌研究会編．大腸癌治療ガイドライン2016年版．
金原出版，東京，2016
３． 日本肝胆膵外科学会編．胆道癌取扱い規約第６版．金
原出版，東京，2013
４． 日本膵臓学会編．膵癌取扱い規約第７版．金原出版，
東京，2016
それぞれの年代におけるそれぞれの臓器の手術後の
謝 辞
生存曲線については、その時々の全国のレベルに比較
しまったく遜色ないものであったと思われる。
手術、術前術後管理に尽力いただいたすべての山形
大学第一外科医局員に感謝いたします。
－97－
Yamagata
木村，渡邊，蜂谷，神尾，矢野，柴田，菅原，岡﨑，川村，鈴木，蘆野，小野寺，高橋，安次富，中野，野津，岩本，田中，赤羽根，武井
Med J（ISSN 0288-030X）2020；38（2）
：87-98
DOI 10.15022/00004878
Results of Surgical treatment in diseases of
gastrointestinal organs, hepato-biliary pancreatic organs,
and the breast in First Department of Surgery Yamagata University,
Post-graduate School of Medicine for 20 years
Wataru Kimura, Toshihiro Watanabe, Osamu Hachiya, Yukinori Kamio, Mitsuhiro Yano,
Kenichi Shibata, Shuichiro Sugawara, Shinji Okazaki, Ichiro Kawamura,Takefumi Suzuki,
Mitsuki Ashino, Yuji Onodera, Ryosuke Takahashi, Yuya Ashitomi, Ryo Nakano,
Shintaro Nozu, Shotaro Iwamoto, Takayuki Tanaka, Ayaka Akabane, Saki Takei
First Department of Surgery Yamagata University, Post-graduate School of Medicine
ABSTRACT
197 esophageal cancer, 1079 gastric cancer, 1146 colorectal cancer, 102 hepatocellular carcinoma, 102
hepatocellular carcinoma, 32 intrahepatic bile duct carcinoma, 32 bile duct The clinical characteristics
and prognosis of surgical cases of 118 cancers, 65 gallbladder cancers, 151 normal pancreatic cancers,
152 intraductal papillary mucinous tumors, 33 pancreatic / duodenal neuroendocrine tumors, and 272
breast cancers are summarized.
As a whole, over the long term of 20 years, medical care（diagnosis, surgical treatment）has
been performed while taking into account the most advanced treatment in each era. Whether or not
preoperative chemotherapy is used and the type of anticancer drug at that time are changing with
age, and there are aspects that have responded to each. The degree of lymph node dissection and
plexus dissection and the degree of organ preservation during surgery have also changed significantly
between 20 years ago and now. Therefore, it may be difficult to closely compare this study with the
postoperative survival curve of a certain disease treated with a specific treatment of a certain age.
This is also a LIMITATION that is supposed to summarize the postoperative results of 20 years.
Conversely, it is meaningful to summarize such long-term results from a certain point of view. The
survival curves after surgery for each organ at each age are comparable to those at the national level.
Keywords: Esophageal cancer, Stomach cancer, Colon cancer, Hepato-biliary pancreatic cancer,
Breast cancer
－98－
...
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