• Title/Summary/Keyword: 위암 환자

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The Prognostic Value of the Preoperative Lymphocyte Count in Patients with Gastric Cancer (위암환자에서 수술 전 말초혈액 림프구 수와 예후)

  • Kang, Shin-Yong;Yu, Wan-Sik;Chung, Ho-Young;Park, Sung-Hun
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.26-30
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    • 2009
  • Purpose: The aim of this study was to evaluate the prognostic value of the peripheral blood lymphocyte count before surgery in those patients with gastric cancer. Materials and Methods: The study group was comprised of a series of 1,054 patients who underwent curative gastrectomy. The appropriate lymphocyte count cutoff value was determined. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The lymphocyte count cutoff value was 1,500/ul. The patients were classified into two groups: Group A had a lymphocyte count $\geq$ 1,500/ul (n=765) and Group B had a lymphocyte count <1,500/ul (n=289). There were statistically significant differences between the groups according to their age (P<0.001), the tumor stage (P=0.038) and the tumor size (P<0.001). The 5- and 10-year survival rates of Group A were 80.1% and 76.6%, respectively and those of Group B were 72.4% and 63.5%, respectively (P=0.002). When multivariate analysis was performed by the Cox proportional hazards model, the lymphocyte count was not an independent prognostic factor. Conclusion: Although the prognosis of patients with a high lymphocyte count was better than that of the patients with a low lymphocyte count, our results did not support using the preoperative peripheral blood lymphocyte count as an independent prognostic factor for patients with gastric cancer.

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Effect of Gastric Cancer Screening on Patients with Gastric Cancer: A Nationwide Population-based Study (위암 환자에서 국가암검진의 효과)

  • Cho, Young Suk;Lee, Sang Hoon;So, Hyun Ju;Kim, Dong Wook;Choi, Yoon Jung;Jeon, Han Ho
    • Journal of Digestive Cancer Research
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    • v.8 no.2
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    • pp.102-108
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    • 2020
  • Background: This study was performed to evaluate the effect of gastric cancer screening through analysis of screening-related data. Methods: We investigated claims data of gastric cancer from 2009 to 2015. We evaluated whether the screening was performed to prior to registration as patients with gastric cancer. The effect of gastric cancer screening was also analyzed by gender. Results: We collected total 196,293 patients with gastric cancer. 74% of them had previous experience of gastric cancer screening. In patients with screening, early gastric cancer was 33.4% and advanced gastric cancer was 17.3%. 22,548 (15.5%) patients were diagnosed with gastric cancer within 2 years after screening. In the case of patients without screening, early gastric cancer was 15.1% and advanced gastric cancer was 25.3%. In case of men, 76% of them confirmed gastric cancer through screening, and 70.2% of women confirmed the gastric cancer. In both men and women, the rate of early gastric cancer was higher among those with screening than those without screening. Conclusion: In this study, we were able to indirectly confirm the stage shift of gastric cancer screening. However, within 2 years after screening, not a few patients with gastric cancer were diagnosed. Therefore, more studies are warranted to in the future.

The Synchronous Occurrence of Splenic Marginal Zone Lymphoma in a Patient with Early Gastric Cancer: A Case Report (조기 위암과 동반된 비장 변연부 림프종 1예)

  • Park, Hyo-Jun;Kim, Keung-Mi;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.63-67
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    • 2009
  • Splenic marginal zone lymphoma (SMZL) is a rare type of non-Hodgkin's lymphoma (NHL). We report here on a patient who displayed the synchronous occurrence of SMZL and early gastric cancer (EGC). The patient was a 74 year-old male with liver cirrhosis. An EGC in the gastric antrum was diagnosed and the preoperative abdomen computed tomography scan revealed splenomegaly and intra-abdominal lymphadenopathy. We performed subtotal gastrectomy and the postoperative pathologic examination revealed adenocarcinoma limited to the gastric mucosa and SMZL in the lymph nodes. The patient recovered from the surgery without complications and is now awaiting chemotherapy. SMZL has an indolent clinical course with good long-term survival and so there is the possibility of the occurrence of a second primary malignancy. Rare cases of a second primary malignancy being diagnosed along with SMZL have been described in the literature. Patients with SMZL should be carefully followed after treatment to detect the possible occurance of a second primary malignancy.

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Relationships between Specific self-efficacy, Family support, and Self-care performance for Patients with Stomach Cancer after Gastrectomy (위암 수술환자의 구체적 자기효능감, 가족지지와 자가간호수행의 관계)

  • Jeon, Yun Hwa;Park, Geum Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.456-465
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    • 2018
  • This study was conducted to investigate the relationships among self-efficacy, family support, and self-care performance of gastric cancer surgery patients. The study was conducted from 11 October to 15 November 2013. Data were collected by self-report questionnaires from 121 patients who were diagnosed with stomach cancer and had undergone surgery at D university hospital in B city and were in follow-up care for 3 months to 5 years after surgery. Data were analyzed using SPSS/PC WIN 18.0 to obtain the percentage, average, mean rating, and standard deviation. In addition, t-test, ANOVA, Scheffe's test, Pearson's correlation and stepwise multiple regression were conducted. The degree of self-care performance in research targets showed significant differences by sex (t=-2.25, p=0.027), religion (F=3.67, p=0.028) and profession (F=4.17, p=0.008). Self-care performance was positively correlated (r=0.60, p<0.001) with the degree of specific self-efficacy. There was a significant difference in self-care performance by specific self-efficacy, religion and gender. The total explanatory power was 37.9% and the explanatory power of the degree of specific self-efficacy (${\beta}=0.53$) was greater than that of other factors. Therefore, it is necessary to provide interventions that improve specific self-efficacy to help patients with gastric cancer patients conduct self-care performance, and practical measures should be made with respect to religion and gender.

Thermoradiotherapy in the Treatment of Advanced Stomach Cancer - To compare the difference between the results of Pre- and post-radiotherapy hyperthermia - (진행성 위암 환자에서 방사선 치료 전후에 실시한 국소온열치료)

  • Kay Chul Seung;Choi Ihl Bohng;Jang Ji Young;Kim In Ah
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.27-33
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    • 1998
  • Purpose : To improve the therapeutic results of postoperative recurrent disease and inoperable disease of stomach cancer, we used the thermoradiotherapy. We conducted a retrospective analysis of the results and compared the results of hyperthermia before radiotherapy and those of hyperthermia after radiotherapy Materials and Methods : From July 1994 to November 1996, we treated twenty patients with locally advanced stomach cancer and recurrent stomach cancer with thermoradiotherapy. We divided those patients into two groups : hyperthermia before radiotherapy group (PreRT group : 13 Patients) and hyperthermia after radiotherapy group (PostRT group : 7 patients). We performed radiation therapy with the total tumor dose of 3000-5040cGy in a traction of 180-300cGy and 5 fractions per week. Hyperthermia was performed with 8 MHz radiofrequency apparatus. PreRT group patients were treated daily for 30 minutes before the radiation therapy within the interval of ten minutes. And PostRT group patients were treated with 1-2 sessions Per week for 40-60 minutes after the radiation therapy within the interval of 10 minutes. Results : Overall response rate was $33.3\%$. This response rate appeared the same in both groups. Mean survival and 1 rear survival rate were 10.3 months and $16.5\%$. In PreRT group, mean survival and 1 year survival rate were 6.8 months and $9.0\%$, and in PostRT group, mean survival and 1 year survival rate were 7.7 months and $34\%$. There were no statistically significant difference between the prognostic factors and therapeutic results. Conclusion : The thermoradiotherapy was a safe treatment method in advanced and recurrent gastric cancer when compared with other treatment. Because the number of patients we treated was small and the follow up period was short. we were not able to draw any conclusions about the therapeutic efficacy of the sequence of radiation therapy and hyperthermia. Therefore, further clinical trials of thermoradiotherauy for stomach cancer appear to be warranted.

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Surgical Treatment of Gastric Cancer

  • Kim, Sang-Woon
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.105-116
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    • 2003
  • Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

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The Results of the ATP Based Chemotherapy Response Assay in Gastric Cancer Tissues (ATP-CRA 방법을 이용한 위암조직의 항암제 감수성 검사결과)

  • Lee, Je-Hyung
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.160-166
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    • 2007
  • Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.

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A Study of Esophageal Acidity and Motility Change after a Gastrectomy for Stomach Cancer (위암 환자의 위절제술 후 식도산도의 변화와 운동장애)

  • Kim Seon-woo;Lee Sang-Ho
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.225-229
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    • 2004
  • Purpose: Some patients develop gastroesophageal reflux disease (GERD) after a gastrectomy for stomach cancer. Therefore, we conducted this research to gain an understanding of esophageal acidity and motility change. Materials and Methods: From July 2002 to March 2004, the cases of 15 randomized patients with stomach cancer who underwent a radical subtotal gastrectomy (RSG) with Billroth I(B-I) reconstruction (n=12) or a radical total gastrectomy (RTG) with Roux-en-Y (R-Y) gastroenterostomy (n=3) were analyzed. We investigated the clinical values of the ambulatory 24-hour pH monitoring and esophageal manometry in these patients, just before discharge from the hospital after an operation. Results: GERD was present in three patients ($20\%$). Compared with two reconstructive procedures, 3 of the 12 patients in the RSG with B-I group had GERD; however, none of RTG with R-Y group had GERD. Compared with pathologic stage, 2 of 9 patients in stage I, 1 of 2 patients in stage II, none of 3 patients in stage III, and none of 1 patient in stage IV had GERD. Esophageal manometry was performed in 10 patients. Nonspecific esophageal motility disorder (NEMD) was present in 7 patients. Conclusion: Some patients had GERD as a complication following a gastrectomy for stomach cancer. We suspect that the postoperative esophageal symptom is due to not only bile reflux but also gastroesophageal acid reflux. Therefore, careful observation is recommended for the detection of GERD.

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Preoperative Evaluation and Anesthesia (수술 전 평가와 마취)

  • 오용석
    • 대한위암학회:학술대회논문집
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    • 2002.04a
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    • pp.37-46
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    • 2002
  • 전통적으로 수술 전 평가는 수술 전날 밤에 시행되는 것이 일반적이었다. 그러나 외래수술을 받는 환자의 증가로 인하여 많은 환자들이 수술 당일 아침에 마취과 의사를 처음 만나게 되는 경우가 많고 심지어는 심각한 내과적 문제를 가진 환자들도 충분한 수술 전 평가가 이루어지지 않은 상태에서 수술실로 들어오게 되는 경우가 있다. 그러나 이러한 상황에서도 마취과의사는 주술기(perioperative period)의 환자 상태를 관리하는 주된 역할자로서 수술 전 환자에 대한 평가를 충실히 해야 한다. 수술 전 평가는 환자의 현재 상태를 평가하는 것이고, 수술 중 발생할 수도 있는 상황에 대비하며, 수술실을 넘어서 중환자실, 통증치료실에서의 마취의사의 역할로 이어지도록 하는 것이다. 최근 발전하고 있는 수술 전 평가 클리닉은 환자의 수술준비의 기초적인 정보를 제공한다. 이는 마취의사에게는 상당한 장점과 편리성을 제공하는 것이고, 환자 관리의 질적 향상과 급변하는 병원관리정책의 요구에 부합하는 것이다.

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The Factors Affecting Health Promotion Behavior among Stomach Cancer Patients (위암환자의 건강증진행위 및 관련 요인)

  • Yun, Hye-Min;Kim, Keon-Yeop;Lee, Tae-Yong;Kim, Hyun-Jee;Kim, Kwang-Hwan;Kim, Dae-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.10
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    • pp.4513-4522
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    • 2011
  • The purpose of this study is to examine the degree of health promotion behavior among stomach cancer patients and its relevant factors, such as belief, family support, and self-esteem etc. To investigate factors affecting health promotion behavior among stomach cancer patients, a survey was conducted through personal interviews with 153 stomach cancer patients who came to two hospitals in Daejeon from June to July, 2008. Questions were about respondents' general characteristics, properties related to stomach cancer, health belief & family support for the disease, and self-esteem. According to the results of multi-variate regression analysis, factors affecting health promotion behavior included age, treatment type, benefit, barrier, family support, and self-esteem which explained 66.6%. Public health and medical interventions are necessary to improve health promotion behavior among stomach cancer patients by improving benefit, family support, and self-esteem and reducing barrier.