• Journal of Gastric Cancer
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• 제10권2호
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• pp.49-54
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• 2010

Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than $500\;{\mu}m$). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.

• Journal of Digestive Cancer Reports
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• 제7권1호
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• pp.8-12
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• 2019

Despite its declining incidence, gastric cancer is globally, still, the third most common cause of cancer-related mortality. Gastric cancer is a heterogeneous disease with diverse pathogenesis and molecular backgrounds. Therefore several systems have been proposed to aid in the classification of gastric adenocarcinoma based on the macroscopic, microscopic and anatomical features of the tumor. However, these classifications did not reflect the pathogenesis of the disease. Recently, genomic analysis has identified several subtypes of gastric adenocarcinoma and a detailed understanding of the molecular biology behind the neoplastic phenotype is possible to develop of more effective therapies. We will describe the existing various classification of gastric cancer and the recently introduced molecular biology and immunological classification.

• 대한간호학회지
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• 제31권1호
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• pp.107-125
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• 2001

This study was designed to construct a structural model for quality of life of chronic gastric disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. Data were collected by questionnaires from 459 patients with chronic gastric disease in a General Hospital from July 1999 to August 2000 in Seoul. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. The results are as follows : 1. The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 1 path and including free parameters and 2 path to it. The modified model with path showed a good fitness to the empirical data ($\chi$2=934.87, p<.0001, GFI=0.88, AGFI=0.83, NNFI=0.86, RMSR =0.02, RMSEA=0.07). 2. The perceived barrier, health promoting behavior, self-efficacy, and self-esteem were found to have significant direct effects on the quality of life. 3. The health concept, health perception, emotional state, and social support were found to have indirect effects on quality of life of chronic gastric disease. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of chronic gastric disease. Therefore it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.159-171
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• 2024

Purpose: Gastric cancer is one of the most common cancers in Korea, and the proportion of upper-third gastric cancers has been steadily increasing over the last two decades. This study aimed to evaluate the effect of tumor location on gastric cancer prognosis. Materials and Methods: We retrospectively reviewed 2,466 patients who underwent gastrectomy for pathologically proven gastric cancer between January 2011 and December 2016. The patients were divided into an upper-third group (U group; n=419, 17.0%) and a middle- and lower-third group (ML group; n=2,047, 83.0%). Clinicopathological characteristics, overall survival (OS), and recurrence-free survival (RFS) after surgery were compared. Results: The U group had more advanced disease than the ML group and a higher incidence of N3b disease for T3 (12.0% vs. 4.9%, p=0.023) and T4 tumors (33.3% vs. 17.5%, p=0.001). The 5-year RFS rate for stage III disease was marginally lower in the U group than that in the ML group (47.1% vs. 56.7%, p=0.082). The upper third location was an independent prognostic factor for both OS (hazard ratio [HR], 1.350; 95% confidence interval [CI], 1.065-1.711) and RFS (HR, 1.430; 95% CI, 1.080-1.823). Conclusions: Upper-third gastric cancer shows extensive node metastasis compared to those located more distally in ≥T3 tumors. The upper third location is an independent prognostic factor for both OS and RFS and may have an adverse impact on RFS, particularly in patients with stage III gastric cancer.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.79-85
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• 2013

There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.99-107
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• 2018

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40-50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.113-120
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• 2015

Purpose: Although several clinical trials have proven the efficacy of adjuvant S-1 treatment in gastric cancers, it is still unclear which patients receive the most benefit. In this study, we prospectively recruited patients with locally advanced gastric cancer who had undergone curative resection followed by adjuvant S-1 administration to investigate which factors affect the outcomes. Materials and Methods: Between July 2010 and October 2011, we enrolled 49 patients who underwent curative resection for stage II or III gastric cancer and who subsequently received adjuvant S-1 treatment for 1 year. Results: Twenty-nine patients (59.2%) continued S-1 treatment for 1 year, and 12 patients (24.5%) experienced recurrent disease during the follow-up period. Patients with continuation of S-1 for 1 year had significantly increased rates of disease-free survival (P<0.001) and overall survival (P=0.001) relative to the patients who discontinued S-1 during year 1. Multivariate analysis indicated poor outcomes for patients with stage III disease and those who discontinued S-1 treatment. Excluding patients who discontinued S-1 due to cancer progression (n=7), adjuvant treatment with S-1 still demonstrated a significant difference in the disease-free survival rate between the patients who continued treatment and those who discontinued it (P=0.020). Conclusions: S-1 is tolerated as adjuvant treatment in gastric cancer patients. However, discontinuing S-1 treatment may be an unfavorable factor in the prevention of recurrence. S-1 adjuvant treatment should be continued for 1 year if possible through the proper management of toxicities.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5643-5646
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• 2012

Background and Objectives: Increase of mortality rates of gastric cancer in Iran and the world in recent years reveal necessity of studies on this disease. Here, hazard function for gastric cancer patients was estimated using Wavelet and Kernel methods and some related factors were assessed. Materials and Methods: Ninety-five gastric cancer patients in Fayazbakhsh Hospital between 1996 and 2003 were studied. The effects of age of patients, gender, stage of disease and treatment method on patient's lifetime were assessed. For data analyses, survival analyses using Wavelet method and Log-rank test in R software were used. Results: Nearly 25.3% of patients were female. Fourteen percent had surgery treatment and the rest had treatment without surgery. Three fourths died and the rest were censored. Almost 9.5% of patients were in early stages of the disease, 53.7% in locally advance stage and 36.8% in metastatic stage. Hazard function estimation with the wavelet method showed significant difference for stages of disease (P<0.001) and did not reveal any significant difference for age, gender and treatment method. Conclusion: Only stage of disease had effects on hazard and most patients were diagnosed in late stages of disease, which is possibly one of the most reasons for high hazard rate and low survival. Therefore, it seems to be necessary a public education about symptoms of disease by media and regular tests and screening for early diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5043-5046
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• 2012

The role of Helicobacter pylori status and serum zinc value in gastric disease patients and healthy controls were investigated. Cases used in this work were 45 gastric cancer patients, 44 with peptic ulcers, 52 suffering gastritis and 64 healthy controls, all diagnosed histologically with the controls undergoing medical checkups. Helicobacter pylori status and serum levels of Zn were determined by 13C-urea breath test and flame atomic absorption spectrophotometer, respectively. Our study showed that Helicobacter pylori infection has no change in gastritis, peptic ulcer and gastric cancer group, on the contrast, serum levels of Zn were significantly reduced in gastritis, peptic ulcer and gastric cancer group, compared with healthy controls, and the higher the Zn levels are, the more increased risk of gastric cancer. Helicobacter pylori infection is a cause of gastritis, peptic ulcers and even gastric cancer, while serum zinc level is an indicator of protection of gastric membranes against damage.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.121-126
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• 2015

Purpose: We evaluated the socio-personal and clinical factors that can affect preoperative quality of life to determine how to improve preoperative quality of life in patients with gastric cancer. Materials and Methods: The preoperative quality of life data of 200 patients (68 females and 132 males; mean age $58.9{\pm}12.6years$) with gastric cancer were analyzed according to socio-personal and clinical factors. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 and the EORTC QLQ-STO22, a gastric cancer-specific module, were used to assess quality of life. Patients were asked to complete the questionnaire preoperatively by themselves. Results: Patients with a higher academic background and stage I disease tended to have higher global health status scores. Highly educated younger men had better physical functioning scores. Highly educated and well-nourished patients with stage I cancer had higher role functioning scores. Married patients had better emotional scores. The symptom scales were affected by sex, age, education level, nutrition, and cancer stage. Conclusions: Preoperative quality of life in patients with gastric cancer can be improved by nutritional support and treatment of symptoms caused by disease progression. Psychological support may be helpful for patients with a poor quality of life.