분무부 위암의 임상적 특성과 예후인자 분석 = Clincal Features and Prognosis of Gastric Cardia Cancer

다국어 초록 (Multilingual Abstract)

Background: Gastric cardia cancer has been rising in incidence and has relatively worse prognosis than that of other site gastric cancer.
Materials and Methods: The clinicopathologic characteristics and prognosis were analyzed for 217 consecutive patients underwent operation for gastric cardia cancer at the Department of Surgery, Seoul National University Hospital from 1991 to 1995 and compared them to those of other site gastric cancer.
Results: The mean age of cardia cancer patients was 54.3 years and male-to-female radio was 2.80 : 1. Gastric resection was performed in 189 patients and curative resection in 171 patients(87.1% resection rate, 78.8% curative resection rate) . Gastric cardia cancer was more advanced than other site gastric cancer. Gastric cardia cancer had worse prognosis than that of non-cardia cancer overall(45.8 % for cardia cancer, 61.2% for non-cardia canner). When we compare the survivals at same stage, survival of cardia cancer was worse than that of non-cardia cancer at stage I and II, but there was no significant difference at stage III and IV. Gross finding, size, depth of invasion, lymphatic invasion, lymph node metastasis, esophageal invasion, and length of proximal resection margin were significant in univariate analysis and in multivariate analysis, depth of invasion and lymph node metastasis were significant prognostic factors. In stave I and II, if the length of proximal resection margin was 3 cm or more, 5 year survival rate was 86.5%, but 61.4% if less than 3cm. However in stage III and IV, there was no survival difference according to the length of resection margin. Despite clear proximal resection margin in frozen biopsies, there were positive resection margin of 5.88% in cases with resection margin of less than 3cm and 1.15% in cases with resection margin more than 3cm(p〈 0.05). These results suggest that length of proximal resection margin should be more than 3cm at least.
Conclusion: Gastric cardia cancer diagnosed at more advanced stage than other site gastric cancer. Poor prognosis of gastric cardia cancer was due to worse survival in stare I and II. To improve the survival of gastric cardia cancer, better means of early diagnosis should be developed and curative resection with more than 3cm resection margin should be performed.

목차 (Table of Contents)

• Ⅰ.서론
• Ⅱ.대상 및 방법
• Ⅲ.결과
• A.임상병리학적 특성과 분문부 이외의 위암과의 비교(Table 1)
• B.전체 환자 및 병기별 생존율 비교
• C.예후 인자 분석
• D.분문부 위암에서 근위부 절제연 3cm에 의한 병기별 생존율 비교(Fig. 3)
• Ⅳ.고찰
• Ⅴ.결론