복막전이가 동반된 위암의 치료

노성훈; 손병호; 민진식

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복막전이가 동반된 위암의 치료

Other Titles: Treatment of Gastric Cancer with Peritoneal Metastasis

Authors: 노성훈 ; 손병호 ; 민진식

Citation: Journal of the Korean Surgical Society (대한외과학회지), Vol.49(1) : 77-83, 1995-07

Journal Title: JOURNAL OF THE KOREAN SURGICAL SOCIETY (대한외과학회지)

ISSN: 1226-0053

Issue Date: 1995-07

Keywords: The incidence of early gastric cancer has continued to increase. However, incidence of peritoneal metastasis at the time of first diagnosis still remains at approximately 10% of the total cases. In these cases, treatment and prognosis are poor. In this study, pathological and clinical characteristics of gastric cancer with peritoneal metastasis were analyzed. In addition, regimen of cytoreductive surgery against primary and metastatic lesions and intraoperative and early postoperative intraperitoneal chemotherapy were compared to palliative surgery and systemic chemotherapy. The study group was comprised 40 patients with pathologically confirmed metastatic gastric cancer. Twenty three out of 40 patients had resection of both the primary and meastatic lesions, remaining 17 patients only had the exploratory laparotomy or gastrojejunostomy with out 17 patients only had the exploratory laparotomy or gastrojejunostomy without resection of lesions. All patients received intraoperative and early postoperative intraperitoneal chemo therapy or systemic chemotherapy. The results are as follows: 1) The study group consisted of 40 patients(23 males and 17 females) with a mean age of 48.8 years. 2) In the resection group, 16 patients received total gastrectomy and 7 patients subtotal gastrectomy. Metastatic lesions were present in 18 peritoneum 6 uterus and ovaries, 4 transverse colons, 2 jejunums, 2 ascending colons, 1 pancreas, and 1 unilateral ovary. 3) In the resection group, majority of the patients had Borrmann type Ⅲ and Ⅳ primary lesions (21 cases, 91.3%). Histologically, poorly differentiated and signet ring cell carcinoma were most frequent (16 cases, 69.6%) 4) Complications in the resection group included 1 case of postoperative obstruction, 4 cases of stomatitis, and 8 cases of leukopenia. 5) There were two cases of mortality within 30 days of surgery among the resection group. The cause of death was due to leukopenia, sepsis, and pulmonary embolism. 6) Four deaths occurred among the resection group during the follow up period. These occurred at 5, 7, 8 and 10 months following surgery. These patients had residual tumor. 7) In the non-resection group, the mean survival was 5.2 months (range 1 to 16 months). Although, the follow up period was different between the 2 groups, generally, the outcome of the resected group was better. In the case of gastric cancer with peritoneal metastasis, complete cytoreductive surgery with adjuvant intraoperative and early post-operative intraperitoneal chemotherapy appears to be relatively safe with better outcome. However, further study is required before true effectiveness of above regimen can be determined.

Files in This Item:: T199501053.pdf Download

Appears in Collections:: 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

Yonsei Authors: Noh, Sung Hoon(노성훈) https://orcid.org/0000-0003-4386-6886

URI: https://ir.ymlib.yonsei.ac.kr/handle/22282913/186272

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