고유근층 위암의 예후와 예후에 영향을 미치는 인자

Abstract

BACKGROUND/AIMS: The purpose of this study was to evaluate the prognosis of gastric proper muscle (pm) cancer and its prognostic factors to identify a high risk group of patients with recurrence.

METHODS: Consecutive 154 patients (mean age, 57.6 years; M:F=2.6:1) with histologically proven gastric pm cancer treated at Yongdong Severance Hospital from January 1986 to December 1998 were reviewed to analyze the prognostic significance of clinical and pathological factors (age, sex, size, location, gross type, cell type, vessel invasion, lymphatic invasion, lymph node metastasis, operative methods, and adjuvant chemotherapy).

RESULTS: The overall 5-year survival rate of gastric pm cancer 83.8%. Lymph node metastasis proved to be an only independent prognostic factor by a multivariate analysis (93.3% without lymph node metastasis vs. 70.8% with lymph node metastasis, p=0.0099). In patients with lymph node metastasis, N stage was found to be an only independent prognostic factor (p=0.0001).

CONCLUSIONS: In this study, lymph node metastasis is the only independent prognostic factor of gastric pm cancer. Gastric pm cancer without lymph node metastasis could be regraded as early gastric cancer. However, gastric pm cancer with lymph node metastasis and advanced nodal stages seems to need some forms of postoperative adjuvant therapy.