위 절제 후 재발된 조기위암 환자의 임상적 특징
Characteristics of Recurred Early Gastric Cancer after Gastric Resection
정순재, 김병식, 오성태, 육정환, 최원용, 이창환,
소속 상세정보
정순재 ( Jung Soon-Jai )
대구가톨릭대학교 의과대학 외과학교실
김병식 ( Kim Byung-Sik )
울산대학교 의과대학 서울아산병원 외과학교실
오성태 ( Oh Sung-Tae )
울산대학교 의과대학 서울아산병원 외과학교실
육정환 ( Yook Jeong-Hwan )
울산대학교 의과대학 서울아산병원 외과학교실
최원용 ( Choi Won-Yong )
울산대학교 의과대학 서울아산병원 외과학교실
이창환 ( Lee Chang-Hwan )
단국대학교 의과대학 외과학교실
KMID : 0371320030650010013
Abstract
Purpose :The proportion of early gastric cancer has recently increased. Although early gastric cancer has a very good prognosis following a curative resection, and recurrences rarely occur, if there is a distant recurrence the prognosis is grave. To predict to the potential of a recurrence after a gastrectomy, early gastric cancer patients were retrospectively analyzed.
Methods :1,131 early gastric cancers were curatively resected at the Asan Medical Center between Jan, 1990 and Sep, 1997. Recurrences were observed in 46 patients during the follow up period. The clinical characteristics of the recurred and cured groups were compared. Any statistical significance was calculated using Chi-Squared and Log rank tests, using SPSS version 10.0.
Results :The recurrence and 5-year survival rates of the recurred patients were and 9%, respectively. Hematogenous recurrences were the most common mode of recurrence, followed by lymph node recurrences. The mean tumor size, numbers of lesions, location of tumor, status of lymph node dissection and operation type, did not affect tumor recurrences. The grossly elevated type of tumor, submucosal layer invasion and differentiated cancer, most frequently recurred. The rate of recurrence linearly increased with increase of the nodal stage. All patients with a lymph node recurrence had lymph node metastasis at the initial surgery.
Conclusion :In early gastric cancer patients, the elevated type, or a differentiated adenocarcinoma, may recur at a distant organ. A more careful follow-up will be required if the surgical removal of a metastatic tumor is intended, as chemotherapy is ineffective. The sentinel lymph node should be examined by a frozen biopsy at the beginning of the initial surgery, in order to determine the range of a lymph node dissection to avoid a nodal recurrence.
키워드
조기위암;재발;생존율
Early gastric cancer;Recurrence;Survival;
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