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조기 위암의 근치적 절제술 후 재발예측인자

Other Titles
 Risk Factors for Recurrence after Curative Surgery for Early Gastric Cancer 
Authors
 신동우 ; 형우진 ; 민진식 ; 노성훈 
Citation
 Journal of the Korean Gastric Cancer Association (대한위암학회지), Vol.1(2) : 106~112, 2001 
Journal Title
 Journal of the Korean Gastric Cancer Association (대한위암학회지) 
ISSN
 1598-1320 
Issue Date
2001
Abstract
Purpose: Even with excellent surgical outcome, recurrence of early gastric cancer (EGC) after a curative resection is not declining because the incidence of EGC is increasing. The aim of this study was to propose an appropriate treatment strategy by assessing the risk factors for recurrence of curatively resected early gastric cancer. Materials and Methods: Of 3662 patients who had undergone gastric resections for gastric cancer from 1987 to 1996, the cases of 1050 curatively resected EGC patients were reviewed retrospectively. Among those 1050 patients, 50 patients (4.8%) were diagnosed as having recurrent cancer, which was confirmed by clinico-radiological examination or re-operation. The risk factors that determined the recurrence patterns were investigated by using univariate and multivariate analyses. Results: The mean time to recurrence was 30.9 months, and hematogenous recurrence was the most frequent type (32.0%). Among the 50 recurred patients, peritoneal recurrence showed the shortest mean time to recurrence (18.5?17.7 months). Between the recurred and the non-recurred patients, there was no statistically significant difference with respect to age, sex, operation type, tumor size, tumor location, gross appearance, or histological differentiation. However, depth of invasion (submucosal invasion) and nodal involvement were significantly different (P<0.001) between the two groups. Using logistic regression analyses, nodal involvement was the only significant risk factor for recurrence in early gastric cancer (P<0.001). The median survival after the recurrencehad been diagnosed was 4 months. Conclusion: Although the prognosis for EGC patients is excellent and recurrence of EGC after a curative resection is rare, the time to recurrence and the patterns of recurrence in EGC patients were diverse and unpredictable, and the result after recurrence is dismal. Considering the impact of lymph node metastasis on recurrence of EGC, a systematic lymphadenectomy, rather than limited surgery, should be performed if lymph node involvement is confirmed pre- or intraoperatively. Also if the postoperative pathologic findings reveal lymph node involvement, adjuvant chemotherapy is recommended.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/142224
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Surgery
Yonsei Authors
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