상부 위암환자에서 위절제 방법에 따른 치료성적
Patients Outcome Following Surgical Treatment of Upper Third Gastric Cancer
류창학, 박재준, 손병호, 한원곤, 배원길,
소속 상세정보
류창학 ( Yoo Chang-Hak )
성균관대학교 의과대학 강북삼성병원 일반외과
박재준 ( Park Jae-Jun )
성균관대학교 의과대학 강북삼성병원 일반외과
손병호 ( Sohn Byung-Ho )
성균관대학교 의과대학 강북삼성병원 일반외과
한원곤 ( Han Won-Kon )
성균관대학교 의과대학 강북삼성병원 일반외과
배원길 ( Pae Won-Kil )
성균관대학교 의과대학 강북삼성병원 일반외과
KMID : 0371320010600010055
Abstract
Purpose: Although there is an increasing incidence of upper third gastric cancers, the appropriate extent of resection for upper third gastric cancer is not known. This study was performed to analyze a 9-year experience with upper third gastric adenocarcinomas from one institution treated by either total gastrectomy (TG) or proximal gastrectomy (PG).
Methods: The records and survival data of 158 upper third gastric cancer patients who underwent curative TG (n=106) or PG (n=52) through an exclusively abdominal approach were retrospectively analyzed.
Results: There was no significant difference in age, sex, tumor gross type, tumor differentiation, and stage between the groups who underwent TG and those who underwent PG. In addition, there were no significant differences in hospital mortality, overall 5-year survival, and disease-free survival rates between PG and TG group. However, PG group showed higher rates of postoperative reflux esophagitis and anastomosis stricture than TG group. Regarding the main patterns of recurrence, local recurrence was dominant in PG group, whereas distant recurrence was dominant in TG group.
Conclusion:The extent of resection for upper third gastric cancer does not affect long-term outcome, and both procedures can be accomplished safely. When the cancer is confined to upper third of the stomach without serosal invasion, PG combined with antireflux procedures can be indicated.
키워드
상부 위암;상부 위절제술;예후
Upper third gastric cancer;Proximal gastrectomy;Prognosis;
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