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J Korean Cancer Assoc > Volume 19(2); 1987 > Article
Journal of the Korean Cancer Association 1987;19(2): 107-114.
재발 위암의 재수술에 관한 임상적 고찰
이창현, 박재갑, 김진복
Clinical Study of Reoperation for Recurred Stomach Cancer
Chang Hyun Lee, Jae Gahb Park, Jin Pok Kim
Ninty two patients received reoperation for the recurrent stomach cancer surgery at the Department of Surgery, Seoul National University Hospital from January 1974 to December 1985. We reviewed the medical records of 89 cases with available pathologic report. At the first operation, serosal invasinn was discovered in 76.4%, lymph node metastasis in 75. 3% and the cellular differentiation was poor in 68.5% of the cases. 66.7% of the cases showed recurrence within 2 years after the first operation. If the primary stomach cancer was deep to the serosal invasion with lymph node metastasis, the cancer was more recurred within 2 years after the first operation and curative reoperation was nearly impossible. The overall postoperative mortality was 10.4%. Curative reoperation could be carried out in 5 cases. Four cases were in patients with no serosal invasion of first operation and only one case was in serosal invasion with lymph node involvement. Relative curative reoperation was applied to the selective 10 cases in which only oophorectomy or mass excision could be done with findings of no other metastatsis at reoperative field. The 2 year survival rate and 5 year survival rate after reoperation of total cases were 11.0% and 2.1% respectively by the cohort life table method. We could find benefit of reoperation for the prolongation of the survival time in 15 cases. The survival time of curative and relative curative reoperation was significantly prolonged than palliative reoperation (P<0.05). The nodal status and the degree of invasion in the gastric wall were important for recurrence rate and reoperability of the stomach cancer.
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