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Clinicopathologic Features and Prognostic Factors for Patients with Large Gastric Tumors
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ÀåÀ¯Áø(Jang You-Jin) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
¹ÚÁß¹Î(Park Joong-Min) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±èÁ¾ÇÑ(Kim Jong-Han) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
¹Ú¼º¼ö(Park Sung-Soo) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±èÁ¾¼®(Kim Chong-Suk) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
¸ñ¿µÀç(Mok Young-Jae) - °í·Á´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
Abstract
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´ë»ó ¹× ¹æ¹ý: 1983³â 9¿ùºÎÅÍ 2001³â 12¿ù±îÁö °í·Á´ëÇб³ ¿Ü°úÇб³½Ç¿¡¼ À§¾ÏÀ¸·Î Áø´ÜµÇ¾î ÀýÁ¦¼úÀ» ½ÃÇà¹ÞÀº 2,260¸íÀ» ´ë»óÀ¸·Î ÈÄÇâÀû ¿¬±¸¸¦ ½ÃÇàÇÏ¿´´Ù. ´ë»ó±ºÀ» Àå°æ 8 cm¸¦ ±âÁØÀ¸·Î ´ëÇüÀ§¾Ï 335 (14.8%)¿¹ ¼ÒÇüÀ§¾Ï 1,925¿¹(85.2%)ÀÇ µÎ ±ºÀ¸·Î ³ª´©¾î ºÐ¼®ÇÏ¿´´Ù. ´ëÇüÀ§¾ÏÀÇ ÀÓ»ó º´¸®ÇÐÀû Ư¼ºÀ» ºÐ¼®Çϱâ À§ÇÏ¿© µÎ ±º °£ÀÇ ÀÓ»ó º´¸®ÇÐÀû ÀÎÀÚµéÀ» ´Ùº¯·® ºÐ¼®°ú ´Üº¯·® ºÐ¼®À» ½ÃÇàÇÏ¿´À¸¸ç »ýÁ¸Àº Cox proportional hazards modelÀ» »ç¿ëÇÏ¿´´Ù. P£¼0.05ÀÎ °æ¿ì¸¦ Åë°èÇÐÀûÀ¸·Î À¯ÀÇÇÑ °ÍÀ¸·Î ÆÇÁ¤ÇÏ¿´´Ù.
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°á·Ð: ´ëÇüÀ§¾ÏÀº ¼ÒÇüÀ§¾Ï¿¡ ºñÇØ ÁøÇàµÈ ¼Ò°ßÀ» º¸¿´´Ù. ´ëÇü À§¾Ï¿¡¼ ±ÙÄ¡ÀýÁ¦´Â »ýÁ¸À²À» Çâ»ó½ÃÅ°´Â ¸Å¿ì Áß¿äÇÑ ÀÎÀÚ·Î ±ÙÄ¡Àû ÀýÁ¦¸¦ À§ÇØ ³ë·ÂÀÌ ÇÊ¿äÇÏ¸ç ±ÙÄ¡Àû ¼ö¼ú °¡´É¼º¿¡ ´ëÇÑ Á»´õ Á¤È®ÇÑ ¼ö¼ú Àü º´±â°áÁ¤¿¡ ÁÖÀǸ¦ ±â¿ï¿©¾ß ÇÒ °ÍÀÌ´Ù.
Purpose: Tumor size has been reported to be one of the prognostic factors in the preoperative setting and 8 cm has been confirmed as a cut-off value for large gastric tumors with respect to postoperative complications. The aim of this study was to investigate the clinicopathologic features and the prognosis in patients with tumors larger than 8 cm in diameter.
Materials and Methods: We retrospectively studied 2,260 patients with gastric cancer who underwent a gastrectomy from 1983 to 2001 at the Department of Surgery, Korea University College of Medicine. For a comparative analysis we divided the cases into the large and the small groups according to tumor size. The clinicopathological factors associated with large gastric tumors were analyzed by using univariate and multivariate analyses. To determine which variables were independent prognostic factors for overall survival, we applied the Cox proportional hazards model and we used P£¼0.05 as the cutoff value for statistical significance.
Results: Univariate and multivariate analyses disclosed that tumor location (P£¼0.001), resection type (P£¼0.001), curability (P£¼0.001), depth of invasion (P£¼0.001), number of metastatic lymph nodes (P£¼0.001), differentiation (P£¼0.001) and combined resection (P£¼0.001) were significantly different between the two groups. The independent factors for survival identified by using the Cox proportional hazards model for large gastric tumors were nodal status (P£¼0.001), curative resection (P£¼0.001), depth of invasion (P=0.010), type of resection (P=0.018) and age (P=0.033).
Conclusion: Large gastric tumors showed more aggressive local findings than their smaller counterparts. In patients with large gastric tumors, a curative resection was the most important factor for the prognosis. Therefore, we suggest that every effort should be made to do a curative gastrectomy and an accurate preoperative examination. (J Korean Gastric Cancer Assoc 2006;6:244-249)
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Gastric cancer, Size, Prognosis
KMID :
0914820060060040244
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patients with large gastric tumors, a curative resection was the most important factor for the prognosis.