잔위암의 임상적 고찰
Clinical Analysis of the Gastric Stump Cancer
김욱, 이준현, 김진조, 진형민, 전해명, 박조현, 박승만, 박우배, 임근우, 김승남,
소속 상세정보
김욱 ( Kim Wook )
가톨릭대학교 의과대학 외과학교실
이준현 ( Lee Jun-Hyun )
가톨릭대학교 의과대학 외과학교실
김진조 ( Kim Jin-Jo )
가톨릭대학교 의과대학 외과학교실
진형민 ( Chin Hyung-Min )
가톨릭대학교 의과대학 외과학교실
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 외과학교실
박조현 ( Park Cho-Hyun )
가톨릭대학교 의과대학 외과학교실
박승만 ( Park Seung-Man )
가톨릭대학교 의과대학 외과학교실
박우배 ( Park Woo-Bae )
가톨릭대학교 의과대학 외과학교실
임근우 ( Lim Keun-Woo )
가톨릭대학교 의과대학 외과학교실
김승남 ( Kim Seung-Nam )
가톨릭대학교 의과대학 외과학교실
KMID : 0371320040660030177
Abstract
Purpose: The aim of this study is to evaluate the clinicopathological features and treatment results of 49 cases of gastric stump cancer based on the classification proposed by the Korean Gastric Cancer Association.
Methods: A total of 49 patients with gastric stump cancer, who underwent operation from 1991 to 2000, were divided into three group: primary cancer (group Ⅰ, n=20), remnant cancer (group Ⅱ, n=15) and recurrent cancer (group Ⅲ, n=14). The clinicopathological features and patient survivors in each groups were analyzed and compared with the primary upper one third cancer patients.
Results: The incidence of operated stump cancer was 0.8% (49/6,445 cases) during the ten years. The male to female ratio was 3.9 : 1 and mean age was 56.5 years (range 39~83 years). The resectability was 96% (47/49 cases) and curability was 73.4% (36/49 cases). There were 16 (80%), 1 (7%), 0 (0%) cases of benign primary disease and 4 (20%), 14 (93%), 14 (100%) cases of malignant primary disease in each group, respectively. The mean duration from primary disease to stump cancer was 21.7 years (10~40 years) in group Ⅰ, 3.4 years (4 months~9 years 2 months) in group Ⅱ and 3.4 years (1 year~7 years 5 months) in group Ⅲ. The 5 year-survival rate was 45.1% in group Ⅰ, 63.5% in group Ⅱ and 0% in group Ⅲ. But there was no statistic differences in 5 year-survival rates between stump cancer (33.0%) and primary cancer of the upper one third (30.9%).
Conclusion: The condition of the primary disease, tumor location, duration of cancer development and tumor stage had statistical differences between the three groups. In the case of benign disease, the patients belonged in the high-risk group for the new development of gastric cancer following 20 years. Early detection of cancer in the remnant stomach by periodic follow up is important, especially in high-risk groups, and application of aggressive surgical treatment will improve patient survival.
키워드
잔위암;분류;생존율;Gastric stump cancer;Classification;Survivals
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