• Title/Summary/Keyword: 위암재발

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Clinicopathologic Characteristics according to the Type of Recurrence in Curatively-resected Gastric Cancer Patients (위암환자의 재발유형에 따른 임상병리학적 특성)

  • Ha, Tae Kyung;Kwon, Sung Joon
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.23-30
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    • 2007
  • Purpose: Evaluating the clinicopathologic characteristics of recurred gastric cancer is essential for early detection of the recurrence and for better clinical outcome. The aim of this study was to establish the patterns of the recurrence, the timing of the recurrence, and the clinical result after recurrence according to the clinicopathologic characteristics of gastric cancer. Materials and Methods: From June 1992 to December 2005, of the 1338 gastric cancer patients who underwent a curative gastric resection, 241 patients who recurred during the follow-up period were selected and their cases were analyzed. The clinicopathologic characteristics of the patients, the time to recurrence after operation and survival were determined retrospectively according to the type of recurrence. Results: For the recurrent group, the numbers of total gastrectomies, advanced stages, lymphatic and/or venous infiltrations, whole stomach cancer cases, large tumors, undifferentiated tumors, and Borrmann type 4 tumors were higher than they were for the non-recurrent group, and the differences were statistically significant. When the recurrence types were classified as peritoneal seeding, hematogenous recurrence, and locoregional recurrence, independent risk factors were female gender, stage III, upper third, and whlole stomach cancer, and undifferentiated- type, diffuse-type, and Borrmann type 4 tumors for peritoneal seeding; early gastric cancer, stage I for hematogenous recurrence; and Borrmann type 1, 2, and 3 tumors for locoregional recurrence. Survival duration after detection of the recurrence was shorter for peritoneal seeding than for hematogenous or locoregional recurrence (7.0 months vs. 9.5 months and 12.5 months). Conclusion: For early detection of the recurrence after curative surgery for gastric cancer, it is important to recognize that the high risk factors for recurrence vary with the clinicopathologic data for the patients.

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A Case of Locally Recurrent Gastric Cancer at Kim's Tie Site of the Jejunum after a Total Gastrectomy (위전절제술 후 Kim 's Tie 부근 공장에 국소 재발한 위암환자 1예)

  • Bae Byung-Gu;Suh Byoung-Jo;Yu Hang-Jong;Kang Yun-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.52-56
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    • 2005
  • Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.

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Clinical Importance of the Resection Margin Distance in Gastric Cancer Patients (위암환자에서 위절제술 시 근위부 절제연거리의 임상적 중요성)

  • Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.277-283
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    • 2006
  • Purpose: The way in which the resection margin distance for gastric cancer patients who undergo a gastric resection influences the recurrence rate, aspects of recurrence, and the prognosis according to the characteristic of the tumor is not known. We aim to find a standard for tailor-made treatment after selecting patients in this point of view who need a more sufficient resection margin. Materials and Methods: A retrospective study was done on 1,472 patients who underwent a gastrectomy due to gastric cancer at our hospital from 1992 to 2005. The median follow-up period was 37 months. Results: There were no significant differences in the recurrence rate, the aspects of recurrence, and the 5-year survival rate between early gastric cancer (EGC) patients with a resection margin distance of less than 2 cm compared with EGC patients with a resection margin distance of greater than 2 cm. However, significant differences in the survival rate were found in advanced gastric cancer (AGC) patients when the patients were classified into groups with resection margin distances less than or greater than 3 cm (P=0.02). Significant differences were noted especially in cases of diffuse histologic-type tumors located in the lower third of the stomach and in cases with Borrmann type-3 and -4 tumors. Conclusion: The distance between the tumor resection margin and the proximal gastric resection margin has no significant influence on the survival rate in EGC patients if the resection margin is negative. However, to improve a patient's survival rate, it is important to guarantee a resection margin of more than 3 cm in AGC patients, especially when the tumor is a diffuse histologic type located in the lower third of the stomach or a Borrmann type 3 and 4.

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