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Clinicopathological features and prognostic factors of proximal gastric carcinoma in a population with high Helicobacter pylori prevalence: a single-center, large-volume study in Korea

Authors
 Jun Chul Park  ;  Yong Chan Lee  ;  Jie-Hyun Kim  ;  Yu Jin Kim  ;  Sang Kil Lee  ;  Sung Kwan Shin  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Choong Bai Kim 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.17(3) : 829-837, 2010 
Journal Title
 ANNALS OF SURGICAL ONCOLOGY 
ISSN
 1068-9265 
Issue Date
2010
MeSH
Carcinoma, Signet Ring Cell/microbiology ; Carcinoma, Signet Ring Cell/pathology* ; Carcinoma, Signet Ring Cell/surgery ; Female ; Follow-Up Studies ; Gastrectomy ; Helicobacter Infections/microbiology ; Helicobacter Infections/pathology* ; Helicobacter Infections/surgery ; Helicobacter pylori/pathogenicity* ; Humans ; Korea ; Liver Neoplasms/microbiology ; Liver Neoplasms/secondary* ; Liver Neoplasms/surgery ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Peritoneal Neoplasms/microbiology ; Peritoneal Neoplasms/secondary* ; Peritoneal Neoplasms/surgery ; Prevalence ; Prognosis ; Stomach Neoplasms/microbiology ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery ; Survival Rate
Keywords
Gastric Cancer ; Pylorus Infection ; Curative Resection ; Early Gastric Cancer ; Advance Gastric Cancer
Abstract
BACKGROUND: The incidence of gastric cancers has fallen in recent decades. However, a substantial reduction in Helicobacter pylori prevalence and a substantial increase in the incidence of proximal gastric cancer (PGC) have been observed in the West and Japan, but not in other East Asian countries. The purpose of this large-volume study was to analyze prevalence, clinicopathological features, and prognosis of PGC compared with other types of gastric cancer in Korea, where there is high incidence of H. pylori infection. METHODS: Between 2000 and 2005, a total of 3,193 patients were enrolled. We analyzed clinicopathological features and survival outcomes. RESULTS: Chronological analysis showed increasing incidence of PGC over the study period. PGC patients were younger and had higher incidence of Bormann types III and IV than did distal gastric cancer (DGC) patients. Also, PGC was associated with a significantly higher proportion of poorly differentiated type, T3 and T4 stage, and positive lymph nodes compared with DGC. Peritoneal and other distant metastases were more common in PGC group than in DGC group. The 5-year survival rate was significantly lower in PGC than in DGC group, regardless of curative resection. Also, the N0 and N1 category significantly influenced the 5-year survival rate. Tumor-node-metastasis (TNM) stage, hepatic metastasis, and curative resection were significant prognostic factors in PGC patients. CONCLUSIONS: PGC has increased in incidence with the respective decline in H. pylori prevalence in Korea. Survival was worse for patients with PGC than for those with DGC, regardless of curative respectability. PGC is often diagnosed at more advanced stage than other gastric cancers, and therefore early detection is critical for successful treatment.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-009-0785-x
DOI
10.1245/s10434-009-0785-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Jin(김유진)
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Kim, Choong Bai(김충배)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100646
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