위 절제술 후 절제연 양성군의 임상병리학적 특성과 재발

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to analyze the clinical courses of patients with gastric cancer and positive resection margins after a gastrectomy for gastric cancer who did not undergo subsequent surgery.
Materials and Methods: Among 4,452 patients who underwent surgery for gastric cancer from January 2001 to December 2007, 20patients with positive resection margins after gastrectomy for gastric cancer who did not undergo subsequent surgery were included.
The recurrence patterns were confirmed by postoperative computed tomography and gastroscopy, which were performed on a planned schedule. All recurrence patterns after gastrectomy were classified as loco-regional, peritoneal, or distant metastases.
Results: The patients with confirmed recurrence all had advanced stage cancer (III–IV), and the recurrence sites were variable. However,peritoneal and distant recurrences were more common than loco-regional recurrences. The patients with loco-regional recurrence also had peritoneal and/or distant recurrence.
Conclusions: Patients with gastric cancer and a positive resection margin showed more frequent peritoneal and distant metastases than loco-regional recurrence. In addition, patients with loco-regional recurrence also had peritoneal and distant recurrence. A positive resection margin of gastric cancer was related with poor histological differentiation, diffuse type, and advanced stage (III–IV).

참고문헌 (Reference)

1 하태경, "위암환자에서 위절제술 시 근위부 절제연거리의 임상적 중요성" 대한위암학회 6 (6): 277-283, 2006

2 권성준, "위암 수술 시 절제연 암침윤의 임상적 의미" 대한위암학회 1 (1): 24-31, 2001

3 Kakeji Y, "Tsujitani S, Maehara Y, et al. Surgical treatment of patients with gastric carcinoma and duodenal invasion" 59 : 215-219, 1995

4 Kim JP, "Results of surgery on 6589 gastric cancer patients and immunochemosurgery as the best treatment of advanced gastric cancer" 216 : 269-278, 1992

5 Hallissey MT, "Resection-line involvement in gastric cancer: a continuing problem" 80 : 1418-1420, 1993

6 Cascinu S, "Resection-line involvement in gastric cancer patients undergoing curative resections: implications for clinical management" 29 : 291-293, 1999

7 Yokota T, "Resection margin in patients with gastric cancer associated with esophageal invasion: clinicopathological study" 53 : 60-63, 1993

8 Morgagni P, "Resection line involvement aft er gastric cancer surgery: clinical outcome in nonsurgically retreated patients" 32 : 2661-2667, 2008

9 Songun I, "Prognostic value of resection-line involvement in patients undergoing curative resections for gastric cancer" 32A : 433-437, 1996

10 Sun Z, "Prognostic significance of microscopic positive margins for gastric cancer patients with potentially curative resection" 16 : 3028-3037, 2009

11 Cho BC, "Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer: a 15-year experience at a single institute" 95 : 461-468, 2007

12 "Practice Guideline in SMC Cancer Center"

13 Roviello F, "Number of lymph node metastases and its prognostic signifi cance in early gastric cancer: a multicenter Italian study" 94 : 275-280, 2006

14 Tsujitani S, "Margins of resection of the esophagus for gastric cancer with esophageal invasion" 42 : 873-877, 1995

15 Kim SH, "Effect of microscopic resection line disease on gastric cancer survival" 3 : 24-33, 1999

16 Morgagni P, "Does resection line involvement affect prognosis in early gastric cancer patients? An Italian multicentric study" 30 : 585-589, 2006

17 Namikawa T, "Clinicopathological features of early gastric cancer with duodenal invasion" 15 : 2309-2313, 2009

18 Yokota T, "Clinicopathologic prognostic features in patients with gastric cancer associated with esophageal or duodenal invasion" 104 : 217-229, 1999

19 Kakeji Y, "Clinicopathologic features and prognostic signifi cance of duodenal invasion in patients with distal gastric carcinoma" 68 : 380-384, 1991

20 D'Angelica M, "Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarcinoma" 240 : 808-816, 2004

21 Bozzetti F, "Adequacy of margins of resection in gastrectomy for cancer" 196 : 685-690, 1982