Korean Gastric Cancer Association-Led Nationwide Survey on Surgically Treated Gastric Cancers in 2019

The Information Committee of the Korean Gastric Cancer Association, The Korean Gastric Cancer Association 2021 Journal of gastric cancer Vol.21 No.3

Purpose: The Korean Gastric Cancer Association (KGCA) has been conducting nationwide surveys on patients with surgically treated gastric cancer, every 5 years, since 1995. This study details the results of the survey conducted in 2019. Materials and Methods: This survey was conducted from March to December 2020 using a standardized case report form, which was sent to every member of the KGCA via e-mail. We collected data on 54 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. We compared the results of the 2019 survey with previous surveys. Results: Data of 14,076 cases were collected from 68 institutions. The mean patient age was 62.9 years and the proportion of patients who were aged ≥71 years increased from 9.1% in 1995 to 28.8% in 2019. The proportion of upper-third tumors steadily increased from 11.2% in 1995 to 20.9% in 2019 and that of early gastric cancer increased from 57.7% in 2009 to 63.6% in 2019. Regarding operative procedures, a total laparoscopic approach was used in more than half of the cases (55.1%) in 2019. The most common anastomotic method was the Billroth II procedure (45.0%) after distal gastrectomy and double tract reconstruction (81.2%) after proximal gastrectomy in 2019. The postoperative mortality rate was 1.0%, and the overall postoperative complication rate was 14.5%. Conclusions: The results of the 2019 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for gastric cancer research in the future.

Complication After Gastrectomy for Gastric Cancer According to Hospital Volume: Based on Korean Gastric Cancer Association-Led Nationwide Survey Data

민재석,정상호,Moon-Won Yoo,Miyeong Park,서경원,Information Committee of the Korean Gastric Cancer Association 대한위암학회 2023 Journal of gastric cancer Vol.23 No.3

Purpose: This study aimed to analyze the incidence and risk factors of complications following gastric cancer surgery in Korea and to compare the correlation between hospital complications based on the annual number of gastrectomies performed. Materials and Methods: A retrospective analysis was conducted using data from 12,244 patients from 64 Korean institutions. Complications were classified using the Clavien-Dindo classification (CDC). Univariate and multivariate analyses were performed to identify the risk factors for severe complications. Results: Postoperative complications occurred in 14% of the patients, severe complications (CDC IIIa or higher) in 4.9%, and postoperative death in 0.2%. The study found that age, stage, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) score, hospital stay, approach methods, and extent of gastric resection showed statistically significant differences depending on hospital volumes (P<0.05). In the univariate analysis, patient age, comorbidity, ASA score, ECOG score, approach methods, extent of gastric resection, tumor-node-metastasis (TNM) stage, and hospital volume were significant risk factors for severe complications. However, only age, sex, ASA score, ECOG score, extent of gastric resection, and TNM stage were statistically significant in the multivariate analysis (P<0.05). Hospital volume was not a significant risk factor in the multivariate analysis (P=0.152). Conclusions: Hospital volume was not a significant risk factor for complications after gastric cancer surgery. The differences in the frequencies of complications based on hospital volumes may be attributed to larger hospitals treating patients with younger age, lower ASA scores, better general conditions, and earlier TNM stages.

2004년 전국 위암 등록사업 결과 보고

대한위암학회 정보전산위원회,The Information Committee of the Korean Gastric Cancer Association 대한위암학회 2007 대한위암학회지 Vol.7 No.1

목적: 대한위암학회 정보전산위원회는 국내 위암의 임상병리학적 양상과 치료 방법에 대한 시대적 변화를 파악하고자 2004년에 위암으로 수술받은 환자들에 대하여 전국조사를 실시하였다. 대상 및 방법: 2004년에 위암으로 수술받은 환자들의 자료를 57개 병원으로부터 수집하였으며, 2002년에 보고되었던 1995년과 1999년의 자료와 비교하였다. 14개 항목(성별, 나이, 위암의 위치와 크기, 육안형, 접근방법, 근치도, 수술종류, 재건술, 국제보건기구 분류 및 Lauren 분류, UICC 병기분류, 전이 및 절제림프절 개수)이 분석되었다. 연중 시행하는 위암수술 규모에 따라 57개 병원을 네 군(1군, <100; 2군, ${\geq}100$ 및 <200; 3군, ${\geq}200$ 및 <500; 4군, ${\geq}500$)으로 나누어 임상항목들을 군간에 비교하였다. 결과: 2004년에 위암으로 수술받은 환자들 11,293명의 자료가 57개 병원으로부터 수집되었다. 남녀비는 2.05:1(7,586/3,705)이었고, 평균 연령은 58.0세였다. 호발연령분포에 있어서 남녀 모두 최근으로 올수록 증가하는 양상을 보였다. 조기위암의 비율은 2004년에 47.4%로 1995년의 28.6%, 1999년의 32.8%에 비해 증가하였다. 절제림프절의 평균개수는 34.0개(1군 32.8개, 2군 34.0개, 3군 36.1개, 4군 32.9개)였다. 결론: 조기위암이 1995년과 1999년에 비해 2004년에 증가하였다. 절제림프절 개수로 볼 때 위암 수술은 병원규모에 무관하게 적정 림프절 절제를 동반한 수술이 이루어지고 있었다. 향후 이 보고가 위암의 진료 및 연구의 참고자료로 활용되기를 기대한다. Purpose: To investigate the characteristics and chronological changes of gastric cancer in Korea, the Information Committee of the Korean Gastric Cancer Association performed nationwide survey for 2004. Materials and Methods: The data on patients who underwent gastric cancer surgery in 2004 were collected from 57 institutes and compared with those of 1995 and 1999 which were reported in 2002. Fourteen factors (sex, age, tumor location and size, gross type, approach to operation, radicality, operative method, reconstruction method, WHO and Lauren classification, UICC stage, and numbers of positive and retrieved lymph nodes) were analyzed. According to the annual number of gastric cancer operations, 57 institutes were divided into 4 groups (group 1, <100; 100 ${\leq}$ group 2 < 200 operations; 200 ${\leq}$ group 3 < 500 operations; group 4, ${\geq}500$). Results: Data on 11,293 patients were collected. The sex ratio (M : F) was 2.05 : 1 (7,586/3,705). The mean age was 58.0 years old. The age of highest incidence in both male and female has increased recently. The proportion of early gastric cancer has increased from 28.6% in 1995 and 32.8% in 1999 to 47.4% in 2004. The mean number of retrieved lymph nodes was 34.0 (32.8, 34.0, 36.1, and 32.9 for group 1, 2, 3, and 4 respectively). Conclusion: Early gastric cancer has increased in 2004 compared to 1995 and 1999. Gastric cancer surgery seems to be performed with acceptable quality in view of number of retrieved lymph nodes. These data presented in nationwide survey could be used as a fundamental resource for gastric cancer in Korea.

Comparison of Laparoscopic and Open Gastrectomy for Patients With Gastric Cancer Treated With Neoadjuvant Chemotherapy: A Multicenter Retrospective Study Based on the Korean Gastric Cancer Association Nationwide Survey

Chang-Seok Ko,Seul Ki Oh,Seong-A Jeong,Jeong Hwan Yook,유문원,Beom Su Kim,In-Seob Lee,Chung Sik Gong,Sa-Hong Min,Na Young Kim,Information Committee of the Korean Gastric Cancer Association 대한위암학회 2023 Journal of gastric cancer Vol.23 No.3

Purpose: Despite scientific evidence regarding laparoscopic gastrectomy (LG) for advanced gastric cancer treatment, its application in patients receiving neoadjuvant chemotherapy remains uncertain. Materials and Methods: We used the 2019 Korean Gastric Cancer Association nationwide survey database to extract data from 489 patients with primary gastric cancer who received neoadjuvant chemotherapy. After propensity score matching analysis, we compared the surgical outcomes of 97 patients who underwent LG and 97 patients who underwent open gastrectomy (OG). We investigated the risk factors for postoperative complications using multivariate analysis. Results: The operative time was significantly shorter in the OG group. Patients in the LG group had significantly less blood loss than those in the OG group. Hospital stay and overall postoperative complications were similar between the two groups. The incidence of Clavien–Dindo grade ≥3 complications in the LG group was comparable with that in the OG group (1.03% vs. 4.12%, P=0.215). No statistically significant difference was observed in the number of harvested lymph nodes between the two groups (38.60 vs. 35.79, P=0.182). Multivariate analysis identified body mass index (odds ratio [OR], 1.824; 95% confidence interval [CI], 1.029–3.234; P=0.040) and extent of resection (OR, 3.154; 95% CI, 1.084–9.174; P=0.035) as independent risk factors for overall postoperative complications. Conclusions: Using a large nationwide multicenter survey database, we demonstrated that LG and OG had comparable short-term outcomes in patients with gastric cancer who received neoadjuvant chemotherapy.

Real-world Nationwide Outcomes of Minimally Invasive Surgery for Advanced Gastric Cancer Based on Korean Gastric Cancer Association-Led Survey

엄방울,박신혜,Mira Han,윤홍만,류근원,Young-Woo Kim,The Information Committee of the Korean Gastric Cancer Association 대한위암학회 2024 Journal of gastric cancer Vol.24 No.2

Purpose: The study aimed to investigate real-world surgical outcomes of minimally invasive surgery (MIS) for advanced gastric cancer using Korean Gastric Cancer Association (KGCA)- led nationwide data. Materials and Methods: A nationwide survey of patients who underwent surgical treatment for gastric cancer in 2019 was conducted by the KGCA. A total of 14,076 patients from 68 institutions underwent surgery, and 4,953 patients diagnosed with pathological stages IB-III gastric cancer were included. Among them, 1,689 patients who underwent MIS (MIS group) and 1,689 who underwent the open approach (open group) were matched using propensity score in a 1:1 ratio. Surgical outcomes were compared, and multivariate analysis was performed to identify the independent factors for overall morbidity. Results: The MIS group had a lower proportion of D2 lymphadenectomy, total omentectomy, and combined resection. However, the number of harvested lymph nodes was higher in the MIS group. Better surgical outcomes, including less blood loss and shorter hospital stay, were observed in the MIS group, and the overall morbidity rate was significantly lower in the MIS group (17.5% vs. 21.9%, P=0.001). The mortality rates did not differ significantly between the 2 groups. In the multivariate analysis, the minimally invasive approach was a significant protective factor against overall morbidity (odds ratio, 0.799; P=0.006). Conclusions: Based on the Korean nationwide data, MIS for stage IB-III gastric cancer had better short-term outcomes than the open approach, including lower rates of wound complications, intra-abdominal abscesses, and cardiac problems.

Korean Practice Guideline for Gastric Cancer 2018; Evidence-based, Multi-disciplinary Approach

Guideline Committee of the Korean Gastric Cancer Association,Development Working Group & Review Panel 대한위암학회 2019 Journal of gastric cancer Vol.19 No.1

Background Gastric cancer is the most common cancer and the fourth most common cause of cancer death in South Korea [1]. Despite the large number of gastric cancer patients newly diagnosed and treated annually in South Korea, there has been no appropriate practice guideline for domestic medical situations. Although Korean guidelines for gastric cancer were published through interdisciplinary collaborations in 2004 and 2014 [2,3], they were not widely used in South Korea. Therefore, we have produced the present clinical practice guideline to create guidelines that can provide the standard of gastric cancer treatment in accordance with the medical reality in South Korea.

Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014

엄방울,안혜성,이인섭,민재석,손영길,이상억,김지훈,이세율,김지현,안상훈,김형호,김영우,The Information Committee of Korean Gastric Cancer Association 대한위암학회 2016 Journal of gastric cancer Vol.16 No.3

Purpose: The Korean Gastric Cancer Association (KGCA) has conducted nationwide surveys every 5 years, targeting patients who received surgical treatment for gastric cancer. We report the results of the 2014 nationwide survey and compare them to those of the 1995, 1999, 2004, and 2009 surveys. Materials and Methods: From March 2015 to January 2016, a standardized case report form was sent to every member of the KGCA via e-mail. The survey consisted of 29 questions, regarding patient demographics as well as tumor-, and surgery-related factors. The completed data forms were analyzed by the KGCA information committee. Results: Data on 15,613 patients were collected from 69 institutions. The mean age was 60.9±12.1 years, and the proportion of patients more than 70 years of age increased from 9.1% in 1995 to 25.3% in 2014. Proximal cancer incidence steadily increased from 11.2% in 1995 to 16.0% in 2014. Early gastric cancer incidence consistently increased and accounted for 61.0% of all cases in 2014. The surgical approach was diversified in 2014, and 7,818 cases (50.1%) were treated with a minimally invasive approach. The most common anastomosis was Billroth I (50.2%) after distal gastrectomy, and the proportion of Roux-en-Y anastomoses performed increased to 8.6%. Conclusions: The results of this survey are expected to be important data for future studies and to be useful for generating a national cancer control program.

2005~2006년 전국 위점막하종양 설문조사 결과 보고

대한위암학회 정보전산위원회,The Information Committee of the Korean Gastric Cancer Association, 대한위암학회 2008 대한위암학회지 Vol.8 No.2

목적: 국내 위 점막하 종양의 임상병리학적 양상과 치료방법에 대해 파악하고자 전국조사를 실시하였다. 대상 및 방법: 국내 47개 병원에서 2005년부터 2006년까지 위 점막하 종양으로 수술 받은 환자 878명의 자료를 수집하여, 진단명, 증상, 위치, 수술법, 사망률, 종양의 크기, 악성도 등을 조사하였다. 결과: 위 점막하 종양의 수술 후 진단으로는 위장관 간질 종양(Gastrointestinal stromal tumor, GIST)이 586명(66.8%)으로 가장 많았고, 평활근종(Leiomyoma) 97명(11.1%), 신경초종(schwannoma) 70명(8.0%), 이소성 췌장(Ectopic pancreas) 68명(7.8%), 유암종(carcinoid) 16명(1.8%) 순이었다. 환자의 평균 나이는 56.0세, 남녀 비는 1:1.18이었으며, 50.9%의 환자가 증상 없이 발견되었다. 위 상부 1/3에 위치한 위 점막하 종양이 가장 흔했으며(n=449, 52.0%), GIST의 55.4% (n=319), 평활근종의 84.5% (n=82)가 위 상부 1/3에 위치하였다. 복강경적 접근이 전체 환자의 44.2% (n=388)에서 시행되었으며, 수술방법으로는 쐐기 절제술(n=726, 82.8%)이 가장 빈번히 시행되었다. 전체 환자 중 1명(0.1%)만이 수술 후 30일 이내에 사망하였다. GIST 환자 중 115명(21.1%, 115/544)이 고위험도의 악성도를 가졌고, 41명(8.3%, 45/495)에서 수술 후 imatinib mesylate 항암 치료를 하였다. 결론: 조사된 국내 점막하 종양의 약 2/3가 GIST였으며, 약 1/2에서 복강경하 절제술이 이루어졌다. 향후 이 보고가 위점막하 종양의 진료 및 연구의 참고자료로 활용되기를 기대한다. Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

Corrigendum: Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014

The Information Committee of Korean Gastric Cancer Association The Korean Gastric Cancer Association 2016 Journal of gastric cancer Vol.16 No.4

Erratum: Korean Practice Guideline for Gastric Cancer 2018: an Evidence-based, Multi-disciplinary Approach

Guideline Committee of the Korean Gastric Cancer Association (KGCA) and Development Working Group & Review Panel The Korean Gastric Cancer Association 2019 Journal of gastric cancer Vol.19 No.3