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J Korean Cancer Assoc > Volume 28(1); 1996 > Article
Journal of the Korean Cancer Association 1996;28(1): 19-27.
위암의 근치적 절제술후 재발
류진우, 김영진, 김신곤
Recurrence after Curative Resection for Gastric Cancer
Jin Woo Ryu, Young Jin Kim, Shin Kon Kim
ABSTRACT
In an effort to help making plans for follow-up and management in patients after initial operation of gastric cancer, ninty two patients who were found to have recurrence after initial curative resection for gastric cancer at the Department of Surgery, Chonnam University Hospital from January 1985 to December 1994 were studied for the recurrence pattern of gastric cancer. Recurrences were detected based on clinical, radiological, endoscopic findings and by operation, and these results were testified by chi square test. The results were as follows; 1) In 92 patients, total of 108 recurrences were identified. 88.0% of total recurrences were intraabdominal.The most common site of recurrence was peritoneal(38.9%), and next was loco-regional(35.2%), liver(13.9%) and extraperitoneal metastasis(12.0%), in order of frequency. 2) Liver metastasis was more frequent in cancers located in antrum(22.0%, p=0.016l), in well differentiated tumor(38.9%, p=0.0032), in Borrmann type II(50.0%,p=0;0044), and in metastasis to Group 1 regional lymph node(29.0%, p=0.0106). 3) Peritoneal recurrence tended to occur more frequently in poorly differentiated cancers (p = 0.047). 4) Extraperitoneal metastasis was more frequent in stage IIIb(23.0%,p=0.0432). 5) In 92 patients, 13 patients received reoperation(14.1%). Curative reoperation could be carried out in 5 cases(5.4%). One patient had liver metastasis and four patients had locoregional recurrence. 6) There was no differences in patterns of recurrence by DNA ploidy patterns. Recurrence patterns after curative resection of gastric cancer showed different features on celllular differentiation of primary tumor, site of primary tumor, stage, and lymph node metastasis. Therefore, this findings may be helpful in planning for postoperative follow-up and adjuvant therapy, and early detection of radically resectable locoregional recurrences.
Key words: Gastric cancer, Recurrence pattern
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