Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Results of Surgical Treatment for Primary Gastric Adenocarcinoma - Single Institute Experience for 14 Years -

위선암에서 외과적 치료 결과 - 단일병원의 14년간 경험 -

  • Cho, Jun-Min (Department of Surgery, Korea University College of Medicine) ;
  • Jang, You-Jin (Department of Surgery, Korea University College of Medicine) ;
  • Kim, Jong-Han (Department of Surgery, Korea University College of Medicine) ;
  • Park, Sung-Soo (Department of Surgery, Korea University College of Medicine) ;
  • Park, Seong-Heum (Department of Surgery, Korea University College of Medicine) ;
  • Mok, Young-Jae (Department of Surgery, Korea University College of Medicine)
  • 조준민 (고려대학교 의과대학 외과학교실) ;
  • 장유진 (고려대학교 의과대학 외과학교실) ;
  • 김종한 (고려대학교 의과대학 외과학교실) ;
  • 박성수 (고려대학교 의과대학 외과학교실) ;
  • 박성흠 (고려대학교 의과대학 외과학교실) ;
  • 목영재 (고려대학교 의과대학 외과학교실)
  • Received : 2009.06.23
  • Accepted : 2009.10.26
  • Published : 2009.12.30
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Abstract

Purpose: The aim of this study was to evaluate the clinicopathologic features, treatment outcomes, and prognostic factors of gastric cancer based on 14 years' experience in a single medical center, and to compare treatment outcomes with a previous study. Materials and Methods: We retrospectively studied 2,327 patients who were operated on for gastric cancer between 1993 and 2006 at Korea University Hospital. Results: The resection rate was 92.8% and curative resection was achieved for 1,960 (90.8%) patients. The 5-year survival rate was 70.0% for all patients undergoing resection and 79.2% for patients undergoing curative resection. The 5-year survival rate was 1.5% for unresected cases. Age, tumor size, location of the tumor, gross tumor type, depth of tumor invasion, lymph node involvement, distant metastasis, tumor stage, combined resection, complications, histology, and type of operation each had prognostic significance on univariate analysis. On multivariate analysis, lymph node involvement, depth of invasion, venous invasion, and age were independent prognostic factors. Conclusion: The 5-year survival rate for patients who underwent curative resection was 79.2%. Depth of invasion, lymph node involvement, venous invasion, and age were independent prognostic factors. The fact that tumor stage is the most important prognostic factor after curative resection, increases the importance of early detection.

목적: 고려대학교 구로병원에서 14년간 위암으로 수술받은 예를 대상으로 임상병리학적 특성, 치료 결과 및 예후 인자를 분석하여 보고자 하였다. 대상 및 방법: 1993년부터 2006년까지 본 교실에서 수술받은 2,327명의 위암 환자를 대상으로 후향적 연구를 하였다 결과: 절제율은 92.8%였고 근치적 절제율은 90.8%였다. 5년 생존율은 절제 예 70.0%, 근치적 절제 예 79.2%, 비근치적 절제 예 3.7% 그리고 비절제 1.5%였으며, 절제 예에서 병기별 5년 생존율은 IA기 98.9%, IB기 94.4%, II기 77.3%, IIIA기 69.3%, IIIB기 38.9% 그리고 IV기 13.6%였다. 예후 인자의 단변량 분석결과 나이, 종양의 크기 및 위치, 육안적 형태, 위벽 침윤, 림프절 전이, 원격 전이가 통계적으로 유의하였고 다변량 분석 결과 독립적 예후 인자는 림프절 전이, 위벽의 침윤도, 정맥 침윤, 연령의 순으로 나타났다. 결론: 위암에서의 예후는 병기에 의해서 가장 많이 영향을 받으므로 예후 향상을 위해서는 조기발견이 가장 중요하고, 적극적이며 체계적인 외과적 치료가 위암의 생존율향상에 기여할 것으로 생각한다.

Keywords

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