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박영태(Young Tae Bak),김진호(Jin Ho Kim),목영재(Young Jae Mok),구범환(Bum Hwan Koo) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
N/A The cases of 630 patients treated surgically at the Department of Surgery, Guro Hospital, Korea, University for primary gastric adenocarcinoma from September 1983 to June 1990 and followed unti December 1991 were reviewed to evaluate survival rate and prognostic variables which might affect survival of the patient. Twenty-seven patients were excluded from the study: 3 patients who died within 30 days of surgery and 24 patients who had incomplete data. A total of 603 patients were available for the study. Tumor resection was possible in 525 out of 603 patients(87.1%.). The 5-year survival rate was 48.0% for 603 patients treated surgically and 54.2%. for 525 patients undergoing resection..'in 78 unversecta ble patients, 3-year suvival rate was 3.2%. Correlation between prognostic variables and survival were attempted in 525 patients who under went resection. Age, sex and tumar location showed no significant influence on survival. This study inidcated that type of cancer, depth of invasion, size of tumor, lymph node metastasis, distant metastasis, histologic type and type of surgical treatment are significant prognostic factors for carcinoma of the stomach.
박성수 ( Sung Soo Park ),목영재 ( Young Jae Mok ) 대한임상종양학회 2008 Korean Journal of Clinical Oncology Vol.4 No.2
수술로써 국소 치료를 종료한 후의 전신적 치료(보조항암요법)의 효과는 대장암과 유방암에서는 확립이 되었지만 위암에서는 그 효과에 대해 전반적인 동의가 없었다. 왜냐하면 위암은 그 호발지역인 우리나라를 비롯한 일본 등 동아시아 지역과 미국 및 유럽에서 발생하는 위암의 지역적인 차이 즉, 임상병리학적 특징과 치료의 원칙인 수술적 치료 방법, 특히 림프절 절제의 정도가 틀려서 서로의 결과를 단순 통합하여 받아들일 수가 없었기 때문이다. 과거 몇 개의 메타분석(meta-analysis)에서 통계적으로 유의한 결과들이 보고되었으나, 그 역시 대상 환자군의 이질성 때문에 임상적으로 의미 있는 결론에 도달할 수 없었다. 그러나 최근의 연구동향은 보조항암요법이 적정한 효용성을 보여주고 있으니 수술과 함께 표준치료의 형태로 나아가야 한다는 경향이다. 이와 같이 위암 표준치료의 개념이 변화하고 있으므로 현재까지 보고된 주요 연구 결과를 파악해 봄으로써 어떠한 요법을 적절한 치료방법으로 선택할 수 있을지 고려해 보아야만 한다. The fact that systemic therapy in addition to definitive regional treatment improves outcome for breast and colon cancer is well established, but whether this is also the case for patients with gastric cancer has not been determined. Despite three recent studies have clearly demonstrated that even modestly effective systemic therapy in combination with surgery produces superior outcomes to surgery alone, no globally accepted standard regimen has yet been established. However, now the benefits of adjuvant chemotherapy seem to be convincing since the advent of the three pivotal studies. Safer, more convenient and more effective chemotherapy combinations are being developed. We need to know about these challenges and how to select the optimal therapy for an individual patient. In this update, I will review the recent studies and provide issues focusing on optimal adjuvant chemotherapy for resectable gastric cancer.