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Title   근치적 위절제술에서 림프절 전이 예측 프로그램의 응용 ( Using the Lymph Node Meatstasis Prediction Program in Curative Resection of Gastric Cancer )
Publicationinfo   1997 Jan; 029(04): 623-632.
Key_word   Systematic lymph node dissection, Gastric cancer
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Abstract   Purpose: The gastric cancer is most frequent malignant disease in Korea. With increase of GNP and social welfare, lot of people pay attention to that. But many of gastric cancer patients who were diagnosed, are advanced -stage III or more- case and produces poor result of treatment. Nowadays many surgeons report that the resection of cancer mass and radical lymph node dissection, which called systematic lymph node dissection, can increase the longterm survival rate and curability of patients. For this purpose Maruyama and his colleagues made a program to predict the 5 year survival rate, cause of death, and the status of lymph node metastases. We put the basic datas of pateints in AGC into Maruyamas program and compare its result to final histologic reports. We would check sesitivity, specificity, positive predictive value, negative predictive values between Maruyamas program and hitologic reports. Materials and Methods: From Sep. 1995 to Sep. 1996, We operated 55 patients with gastric cancer with this program in GNUH. We checked the histopathologic reports and put the data into the prediction program. The datas were sex, age, maximal size of tumor, differentiation, gross type and location. We compared status of lymph node metastases, TNM stages between the reports of histopathology and that of predictive program. Results: In early stages the sensitivity and specificity of the program showed poor result but in advanced stages did not. The distribution of lymph node metastasis showed a same pattern. The patterns of perigastric lymph node metastasis were somewhat different according to the location of tumor. But its significance was not confirmed. We analysed the metastaic rate between lymph node groups and compared with the results between two reports. The sensitivity, and negative predictive value were 100% in each groups, and positive predictive value was also high. Conclusion: The systematic lymph node dissection is an effective and safe procedure in the surgical treatment of gastric cancer. We suggest that the techniques should be standardized and popularized in Korea. This procedure will improve the survival rate of gastric cancer patients and decrease the local recurrence of gastric cancer.
저 자   이정훈(Jung Hoon Lee),하우송(Woo Song Ha),이영준(Young Joon Lee),권수인(Soo In Kwon),박순태(Soon Tae Park),조영현(Young Hyun Cho),이영재(Young Jae Lee),권진용(Jin Yong Kwon),강병길(Byung Gin Kang),정민화(Min Hwa Jung),손신(Sin Son)