Choi, Ji-Yoon
(Department of Surgery, Hanyang University College of Medicine)
,
Ha, Tae-Kyung
(Department of Surgery, Hanyang University College of Medicine)
,
Kwon, Sung-Joon
(Department of Surgery, Hanyang University College of Medicine)
Purpose: There are few studies that have focused on the predictors of recurrence after gastrectomy for gastric carcinoma. This study analyzed the patients who died of recurrent gastric carcinoma and we attempted to clarify the clinicopathologic factors that are associated with the timing of recurren...
Purpose: There are few studies that have focused on the predictors of recurrence after gastrectomy for gastric carcinoma. This study analyzed the patients who died of recurrent gastric carcinoma and we attempted to clarify the clinicopathologic factors that are associated with the timing of recurrence. Materials and Methods: From June 1992 to March 2009, 1,795 patients underwent curative gastric resection at the Department of Surgery, Hanyang University College of Medicine. Among them, 428 patients died and 311 of these patients who died of recurrent gastric carcinoma were enrolled in this study. The clinicopathologic findings were compared between the 72 patients who died within one year after curative gastrectomy (the early recurrence group) and the 92 patients who died 3 years after curative gastrectomy (the late recurrence group). Results: Compared with the late recurrence group, the early recurrence group showed an older age, a more advanced stage, a poorly differentiated type of cancer and a significantly higher tendency to have lymphatic invasion, vascular invasion and perineural invasion.Especially in the gastric cancer patients with a more advanced stage (stage III and IV), the early recurrence group was characterized by a significantly higher preoperative serum carcino embryonic antigen level, perineural invasion and a relatively small number of dissected lymph nodes. Conclusions: The clinicopathologic characteristics of recurrent gastric cancer are significantly different according to the stage of disease, and even in the same stage. For the early detection of recurrence after curative surgery, it is important to recognize the clinicopathological factors that foretell a high risk of recurrence. It is mandatory to make an individualized surveillance schedule according to the clinicopathologic factors.
Purpose: There are few studies that have focused on the predictors of recurrence after gastrectomy for gastric carcinoma. This study analyzed the patients who died of recurrent gastric carcinoma and we attempted to clarify the clinicopathologic factors that are associated with the timing of recurrence. Materials and Methods: From June 1992 to March 2009, 1,795 patients underwent curative gastric resection at the Department of Surgery, Hanyang University College of Medicine. Among them, 428 patients died and 311 of these patients who died of recurrent gastric carcinoma were enrolled in this study. The clinicopathologic findings were compared between the 72 patients who died within one year after curative gastrectomy (the early recurrence group) and the 92 patients who died 3 years after curative gastrectomy (the late recurrence group). Results: Compared with the late recurrence group, the early recurrence group showed an older age, a more advanced stage, a poorly differentiated type of cancer and a significantly higher tendency to have lymphatic invasion, vascular invasion and perineural invasion.Especially in the gastric cancer patients with a more advanced stage (stage III and IV), the early recurrence group was characterized by a significantly higher preoperative serum carcino embryonic antigen level, perineural invasion and a relatively small number of dissected lymph nodes. Conclusions: The clinicopathologic characteristics of recurrent gastric cancer are significantly different according to the stage of disease, and even in the same stage. For the early detection of recurrence after curative surgery, it is important to recognize the clinicopathological factors that foretell a high risk of recurrence. It is mandatory to make an individualized surveillance schedule according to the clinicopathologic factors.
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제안 방법
2%) (the early recurrence group) whose recurrence time was within 1 year after surgery, 2) 92 patients (29.6%) (the late recurrence group) whose recurrence occurred 3 years after surgery and 3) 147 patients (47.2%) (the mid recurrence group) who had recurrent disease between 1 year to 3 years after surgery (Fig. 1), and the clinicopathological characteristics of the early recurrence group and the late recurrence group were compared and analyzed.
대상 데이터
Among them, we excluded the patients that the cause of death was not known (n=50), the patients who died due to accidents (n=11), the patients who died due to cancer in other organs (n=17) and the patients who died of other benign diseases (n=39). Finally, this study was conducted on 311 patients who died due to recurrent gastric cancer (Table 1). A radical resection was done for the patients without distant metastasis and without infiltration to the adjacent organs, the patients with infiltration and without macroscopic residual cancer and the patients who underwent lymphadenectomy higher than D2.
데이터처리
Student’s t-test was applied for comparing the various clinicopathological characteristics associated with recurrence.
성능/효과
64%) of the late recurrence group (recurred after 2 years), and they compared the clinicopathological characteristics. It was observed that in the early recurrence group, the average size of tumors was significantly larger (P＜0.01) and the cases with lymph node metastasis (P=0.01), lymph duct infiltration (P＜0.01) and advanced disease stages (P=0.01) were significantly more abundant.
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