진행성 위암의 근치적 절제술 후 재발에 영향을 주는 인자
Factors Influencing Recurrence after Curative Resection for Advanced Gastric Cancer
김찬동, 장명철, 노혜린, 채기봉, 양대현, 최원진,
소속 상세정보
김찬동 ( Kim Chan-Dong )
강원대학교 의과대학 외과학교실
장명철 ( Jang Myung-Chul )
강원대학교 의과대학 외과학교실
노혜린 ( Roh Hye-Rin )
강원대학교 의과대학 외과학교실
채기봉 ( Chae Gi-Bong )
강원대학교 의과대학 외과학교실
양대현 ( Yang Dae-Hyun )
한림대학교 의과대학 외과학교실
최원진 ( Choi Won-Jin )
강원대학교 의과대학 외과학교실
KMID : 0371320030650040301
Abstract
Purpose :Despite radical lymph node dissection and combined resection, the operative results of treating advanced gastric cancer remains inadequate. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the pattern of recurrence after curative resection for advanced gastric cancer.
Methods :Out of 220 patients who underwent curative resection for advanced gastric cancer from 1990 to 2000, 50 whose recurrence was confirmed by clinical, radiological, endoscopic or reoperative findings were studied retrospectively. We undertook a detailed analysis of the pattern of recurrence based on the morphologic and histopathologic characteristics of the initial tumor.
Results :The mean time to recurrence was 19.0 months. Early recurrence was found in 38 patients (76.0%), intermediate recurrence was found in 11 patients (22.0%), and late recurrence was found in 1 patient (2.0%). The patterns of recurrence were as follows: hepatic recurrence was found in 14 cases, peritoneal recurrence in 19 cases, local recurrence in 10 cases, extraperitoneal recurrence in 6 cases. In univariate analysis, the depth of invasion, extent of lymph node metastasis, TNM stage, and combined resection were important for recurrence. In multivariate analysis, depth of invasion and lymph node metastasis were important for recurrence.
Conclusion :The peritoneal recurrence was the most frequently encountered pattern of recurrence. The two years following surgery was the most important period for recurrence. Depth of invasion and lymph node metastasis were related to recurrence with statistical significance. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.
키워드
위암;재발;
Gastric cancer;Recurrence
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