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Title   조기위암의 재발양상에 대한 임상병리학적 연구 ( Clinicopathological Analysis for Recurrence after Surgery for Early Gastric Cancer )
Publicationinfo   2000 Jan; 032(02): 312-321.
Key_word   Stomach neoplasm, Early gastric cancer, Recurrence, Lymph node metastasis
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Abstract   Purpose: The incidence of early gastric cancer (EGC) is increasing in Korea. The prognosis of EGC is excellent but a small portion of patients experience recurrence after curative resection. We aimed to study recurrence rate of EGC, recurrence pattern of EGC and to find predicting factors for recurrence. We analyzed treatment results after recurrence in EGC. Materials and Methods: One thousand four hundred fifty eight patients with EGC at Department of Surgery, Seoul National University Hospital (1986~1995) were reviewed for recurrence retrospectively. Results: Twenty-six patients had recurrence after curative resection (1.79%). Thirteen cases (50%) recurred within 24 months (early recurrence) and late recurrence after 60 months occured in 4 cases (15%). The common modes of recurrence were locoregional (9, 34.6%) and distant metastasis (9, 34.6%). Submucosal invasion was in 19 cases and lymph node metastasis was positive in 14 cases. Median survival after recurrence was 5.6 months. Median survival after recurrence was 3.1 months after conservative management, 5.8 months after chemotherapy, and 46.8 months after resection. Recurrence rate was significantly higher in submucosal invasion group than mucosal invasion group (2.6% vs. 1.0%, p<0.05) and lymph node metastasis positive group than negative group (7.4% vs. 1.0%, p <0.001) by univariate analysis. Multivariate analysis revealed significantly high correlation between positive lymph node metastasis and recurrence (p < 0.001). Conclusion: Lymph node metastasis is the most significant predictor of recurrence. Resection for locoregional recurrence can be beneficial.
저 자   정기욱(Ki Wook Chung),조삼제(Sam Je Cho),양한광(Han Kwang Yang),김우호(Woo Ho Kim),이건욱(Kuhn Uk Lee),최국진(Kuk Jin Choe),김용일(Yong Il Kim),김진복(Jin Pok Kim)