장막하층 위암의 성장양상이 예후에 미치는 영향
The Effect of Growth Patterns on the Prognosis of Gastric Cancer Invading Subserosa
송교영, 김진조, 진형민, 김욱, 전해명, 박승만, 임근우, 김승남, 박우배, 박조현,
소속 상세정보
송교영 ( Song Kyo-Young )
가톨릭대학교 의과대학 외과학교실
김진조 ( Kim Jin-Jo )
가톨릭대학교 의과대학 외과학교실
진형민 ( Chin Hyung-Min )
가톨릭대학교 의과대학 외과학교실
김욱 ( Kim Wook )
가톨릭대학교 의과대학 외과학교실
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 외과학교실
박승만 ( Park Seung-Man )
가톨릭대학교 의과대학 외과학교실
임근우 ( Lim Keun-Woo )
가톨릭대학교 의과대학 외과학교실
김승남 ( Kim Seung-Nam )
가톨릭대학교 의과대학 외과학교실
박우배 ( Park Woo-Bae )
가톨릭대학교 의과대학 외과학교실
박조현 ( Park Cho-Hyun )
가톨릭대학교 의과대학 외과학교실
KMID : 0371320040670020112
Abstract
PURPOSE: Advanced gastric cancer that invades the subserosa can be classified into three subgroups according to the tumor cell growth patterns: expansive growth (ss alpha), infiltrative growth (ss gamma) and intermediate growth (ss beta). Serosal invasion is a well-known risk factor for peritoneal recurrence. It has been reported that the risk of peritoneal seeding of ssgamma is comparable with serosal tumor, although tumor cells do not actually reached the serosa as one of the histologic findings. In this study, the clinicopathologic features of subserosal tumors according to the growth pattern were analyzed.
METHODS: One hundred and twenty-nine patients who underwent a gastrectomy for gastric cancer invading the subserosa at the Department of Surgery, Kangnam St. Mary’s Hospital, The Catholic University of Korea, between 1994 and 1998, were retrospectively evaluated. No patients had any other organ tumor. The patients were divided into two groups: 86 non-infiltrative cancers (Group I, ss alpha and ss beta) and 43 infiltrative cancers (Group II, ss gamma) according to the tumor growth pattern.
RESULTS: Undifferentiated carcinomas were more frequent group II than group I (83.7% vs. 27.9%, P=0.000). There was no difference in any of the other clinicopathological characteristics between the two groups, including age, gender, tumor size or lymph node metastasis. However, the recurrence patterns were significantly different between the two groups. The peritoneal recurrence rate was higher in group II than group I (71.4% vs 39.3%, P=0.036). The 5 and 10-year survival rates were 66.9 and 61.2% for group I and 50.4% and 40.4% for group II, respectively (P>0.05).
CONCLUSION: A high incidence of peritoneal recurrence was noted in the infiltrative subserosal gastric cancer. Therefore, attention should be focused on the diagnosis of peritoneal recurrence during follow-up for this subtype of subserosal cancer.
키워드
장막하층암; 성장양상; Subserosal tumor; Growth pattern
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