위암에서 국소림프절 전이수에 따른 림프절 분류와 제5판 UICC TNM 림프절 분류와의 비교
Nodal Staging by Number of Metastatic Lymph Node and Comparison with Nodal Staging of 5th UICC TNM Classification in Gastric Cancer
허준, 홍정훈, 목영재, 김미경,
소속 상세정보
허준 ( Heo Jun )
고려대학교 의과대학 외과학교실
홍정훈 ( Hong Jeong-Hun )
고려대학교 의과대학 외과학교실
목영재 ( Mok Young-Jae )
고려대학교 의과대학 외과학교실
김미경 ( Kim Mi-Kyung )
고려대학교 통계학연구소
KMID : 0371320020630030206
Abstract
Purpose: The nodal staging of the 5th edition of the Union Internationale Contra la Cancer (UICC) TNM classification in 1997 was changed based on the number of metastatic lymph nodes. We attempted to classify nodal status according to the
number
of involved lymph nodes and compare with the nodal staging of the 5th UICC TNM classification in order to evaluate the rationality of the new nodal staging system.
Methods: The authors retrospectively analyzed 427 patients with gastric cancer who underwent curative resection from 1993 to 1996 at the Department of Surgery, Korea University College of Medicine. Cumulative survival rates were calculated
by the
Kaplan-Meier method. The difference between each nodal status was evaluated by the log rank test and the generalized Wilcoxon test.
Results: There were statistical differences between 0 and 1 lymph node involved, between 7 and 8, and between 15 and 16. We classified the nodal status into 4 groups according to the number of involved lymph nodes based on the following:
group 1
with no lymph node involved, group 2 with 1∼7, group 3 with 8∼15 and group 4 with more than 15. There was a significant survival difference among the 4 groups with no survival difference between the number of positive lymph nodes in each group.
We
compare our results with the nodal staging of the UICC TNM classification and found that there were differences between group 2 (1∼7 positive lymph nodes) and pN1 of TNM (1∼6 positive lymph nodes) and between group 3 (8∼15) and pN2
(7∼15).
Conclusion: We were able to classify nodal status into 4 groups according to the number of involved lymph nodes. There was little difference compared with the new nodal staging of the 5th UICC TNM classification, which suggested that the
nodal
classification of the UICC TNM classification based on the number of metastatic lymph nodes is acceptable. Further analysis of a larger sample size may be necessary.
키워드
위암; 전이림프절 분류; UICC TNM 분류; Gastric cancer; Nodal staging; UICC TNM classification;
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