조기위암의 재발양상에 대한 임상병리학적 연구
Clinicopathological Analysis for Recurrence after Surgery for Early Gastric Cancer
대한암학회지 2000년 32권 2호 p.312 ~ 320
정기욱, 조삼제, 양한광, 김우호, 이건욱, 최국진, 김용일, 김진복,
소속 상세정보
정기욱 ( Chung Ki-Wook )
서울대학교 의과대학 외과학교실
조삼제 ( Cho Sam-Je )
서울대학교 의과대학 외과학교실
양한광 ( Yang Han-Kwang )
서울대학교 의과대학 외과학교실
김우호 ( Kim Woo-Ho )
서울대학교 의과대학 병리학교실
이건욱 ( Lee Kuhn-Uk )
서울대학교 의과대학 외과학교실
최국진 ( Choi Kook-Jin )
서울대학교 의과대학 외과학교실
김용일 ( Kim Yong-Il )
서울대학교 의과대학 병리학교실
김진복 ( Kim Jin-Pok )
서울대학교 의과대학 외과학교실
KMID : 0360320000320020312
Abstract
Purpose :The incidence of early gastric cancer (EGC) in increasing in Korea. The prognosis of EGC is excellent but a small portion of patients experience recurrence after curative resection. We aimed to study recurrence rate of EGC, recurrence pattern of EGC and to find predicting factors for recurrence. We analyzed treatment results after recurrence in EGC.
Materials and Methods :One thousand four hundred fifty eight patients with EGC at Department of Surgery, Seoul National University Hospital (1986 ∼1995) were reviewed for recurrence retrospectively.
Results : Twenty-six patients had recurrence after curative resection (1.79%). Thirteen cases (50%) recurred within 24 months (early recurrence) and late recurrence after 60 months occurred in 4 cases (15%). The common modes of recurrence were locoregional (9, 34.6%) and distant metastasis (9, 34.6%). Submucosal invasion was in 19 cases and lymph node metastasis was positive in 14 cases. Median survival after recurrence was 5.6 months after chemotherapy, and 46.8 months after resection. recurrence rate was significantly higher in submucosal invasion group than mucosal invasion group (2.6% vs. 1.0%, p<0.05) and lymph node metastasis positive group than negative group (7.4% vs. 1.0%, p<0.001) by univariate analysis. Multivariate analysis revealed significantly high correlation between positive lymph node metastasis and recurrence (p<0.001).
Conclusion :Lymph node metastasis is the most significant predictor of recurrence. Resection for locoregional recurrence can be beneficial.
키워드
Stomach neoplasm;Early gastric cancer;Recurrence;Lymph node metastasis;
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