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원저: 제Ib병기위암의 임상적 고찰 (Clinical Analysis of Stage Ib Gastric Cancer)

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제 Ib 병기위암의 임상적 고찰

Clinical Analysis of Stage Ib Gastric Cancer

Seok Hyung Kang, M.D.

1

, Keun Won Ryu, M.D.

1

, Seung Joo Kim, M.D., Young Jae Mok, M.D., Chong Suk Kim, M.D. and Bum Hwan Goo, M.D.

Purpose: The aim of this study was to clarify the clinico- pathological differences between T1N1M0 and T2N0M0, par- ticularly the survival rates, and the role of chemotherapy in the stage Ib gastric cancer.

Methods: From January 1992 to December 1999, 118 cases were confirmed as having stage Ib gastric cancer in the Korea University Medical Center. Among them 31 patients were classified as being T1N1M0 and the other 87 cases were T2N0M0. The clinicopathological features and the prognosis were evaluated retrospectively.

Results: The overall 5-year survival rate of the stage Ib gastric cancer patients was 94%. Overall 5-year survival rates in T1N1M0 and T2N0M0 were 100% and 91%, respec- tively. Though T1N1M0 group showed better prognosis, there was no significant difference between two groups (P=0.14).

D1, D2, and D2+ resections were performed in 28 cases (23.7%), 81 (68.6%), and 9 (7.6%), respectively, and there was no difference in the survival rate (P 0.05). The 5-year survival rates were analyzed according to whether or not they had received chemotherapy. There was a 98% 5-year survival rate with those who had chemotherapy and a 90%

5-year survival rate with those who had not had chemo- therapy, but there was no significant difference between them (P=0.18). In the T2N0M0 group, the 5 year survival rates of patients with or without chemotherapy were 97%

and 86%, respectively, but there was no significant differ- ence (P=0.16).

Conclusion: Though T1N1M0 group showed a better prog- nosis than the T2N0M0 group, there was no significant differ- ence between the two groups (P=0.14). There was no significant

survival difference between D1, D2, or D2+ procedures.

It appears that post operative intravenous chemotherapy does not affect the prognosis of stage Ib gastric cancer, and the role of the chemotherapy in patients with T2N0M0 diseases is minimal. (J Korean Surg Soc 2002;63:305-311) Key Words: Chemotherapy, Clinicopathologic feature, Gastric

cancer, Prognosis, Stage Ib

: , , ,

, Ib

Department of Surgery, Korea University College of Medicine,

Seoul, Korea,

1

Gastric Cancer Center, National Cancer Center,

Goyang, Korea

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