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J Korean Cancer Assoc > Volume 29(4); 1997 > Article
Journal of the Korean Cancer Association 1997;29(4): 623-631.
Using the Lymph Node Metastasis Prediction Program in Curative Resection of Gastric Cancer
Jeong Hun Lee, Woo Song Ha, Young Jun Lee, Su In Kwon, Soon Tae Park, Young Hyeon Cho, Young Jae Lee, Jin Yong Kwon, Byeong Gil Kang, Min Hwa Jeong, Sin Shon
1Department of Surgery, College of Medicine, Gyeongsang National University, Korea.
2Gyeongsang Institute of Cancer Research Gyeongsang National University, Korea.
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 Maruyama's 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.
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.
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.
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.
Key words: Systematic lymph node dissection;Gastric cancer
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