조기위암 환자의 예후인자와 위암 특이 사망률의 분석과 그 임상적 의의
Analyses of Prognostic Factors and Gastric Cancer Specific Survival Rate in Early Gastric Cancer Patients and Its Clinical Implication
형우진, 정재호, 김준억, 첸지안, 최승호, 노성훈,
소속 상세정보
형우진 ( Hyung Woo-Jin )
연세대학교 의과대학 외과학교실
정재호 ( Cheong Jae-Ho )
연세대학교 의과대학 외과학교실
김준억 ( Kim Jun-Uk )
연세대학교 의과대학 외과학교실
첸지안 ( Chen Ji-An )
연세대학교 의과대학 외과학교실
최승호 ( Choi Seung-Ho )
연세대학교 의과대학 외과학교실
노성훈 ( Noh Sung-Hoon )
연세대학교 의과대학 외과학교실
KMID : 0371320030650040309
Abstract
Purpose :This study was performed to find out the risk factors for recurrence and prognosis of early gastric cancer (EGC) patients by evaluating the recurrence, overall survival, and disease-specific survival after curative resection.
Methods :Out of 4217 patients who had undergone gastric resections for gastric adenocarcinoma from 1987 to 1997, the records of 1264 curatively resected EGC patients were reviewed retrospectively, Risk factors that determined recurrence, overall survival, and stomach cancer specific survival were investigated by using uni-variate and multi-variate analyses.
Results :Among the 1264 patients, 62 patients (4.9%) were diagnosed as having recurrent cancer and 162 patients died during follow-up. Of these 162 patients, 53 (4.2% of 1264, 32.7% of 162) patients died of gastric cancer whereas 92 died of non-gastric cancer causes and 17 died of unknown causes. In uni-variate analyses, the depth of invasion and lymph node metastasis were risk factors for recurrence and gastric cancer-specific survival while age, histologic type, depth of invasion, and lymph node metastasis were risk factors for overall survival. In multi-variate analysis, lymph node metastasis was the only risk factor for recurrence and gastric cancer-specific survival, while age was the only risk factor for overall survival. In a detailed analysis of prognoses based on lymph node metastasis, recurrence and gastric cancer related death were more frequently noted in patients with 3 or more lymph node metastasis and with extraperigastric lymph node metastasis.
Conclusion :Although EGC patients treated by curative resection showed good prognosis, those with lymph node metastasis have risks of recurrence and gastric cancer-related death, Considering the high rate of recurrence and gastric cancer-related death, more attention should be given to EGC patients with 3 or more lymph node metastases and/or extra-perigastric lymph node metastases, Adjuvant chemotherapy might be recommended for these high-risk patients.
키워드
조기위암;재발;전체 생존율;질병 특이 생존율;
Early gastric cancer;Recurrence;Overall survival;Disease specific survival
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