위절제술을 시행한 위암환자 3,720례의 생존율 및 예후인자 분석

Abstract

In this retrospective study, 3,720 patients with gastric cancer who underwent gastric resection at Department of Surgery, Keimyung University Dongsan Medical Center from January 1990 to December 2006 were reviewed to analyze the clinicopathological characteristics, survival rate and prognostic factors. The author analyzed 11 clinicopathological variables (sex, age, tumor location and size, gross and histologic type, Lauren classification, type of operation, depth of gastric wall invasion, lymph node metastasis, and stage). The male (2,474 patients) to female (1,246 patients) ratio was 1.99 : 1 and peak age incidence was in the 7th decade with a mean age of 57.33 ± 11.52 years (range: 19~87 years). The most common location of the tumor was the lower one third of the stomach (59.0%). Depressed type (84.3%) in early gastric cancer and Borrmann type III (65.4%) in advanced gastric cancer were the most common gross type. The major histologic type was poorly differentiated tubular adenocarcinoma (42.0%). In Lauren classification, the incidence of diffuse type (46.7%) and that of intestinal type (46.3%) were similar. The incidence of early gastric cancer was 45.8%. The operations performed were subtotal gastrectomy in 3,115 patients (83.7%) and total gastrectomy in 598 patients (16.1%). The postoperative mortality rate was 0.8%. The overall 5-year survival rate was 70.5%. The univariate analysis for prognosis reveals that increasing age, tumor location in upper one third, larger tumor size, Borrmann’s type Ⅲ and Ⅳ tumors, poorly differentiated histologic type, diffuse type in Lauren classification, total gastretomy, increasing pT and pN classification, and advanced tumor stage were significantly related to poor prognosis. The multivariate analysis revealed that lymph node metastasis, depth of invasion, age and Borrmann's classification were independent prognostic factors.