4기위암 환자의 임상적 특성

Abstract

(Purpose) Recently early detection of gastric cancer and rate of preoperative staging are increasing due to development of endoscopy and imaging technique, but there are still many cases of advanced gastric cancer at first diagnosis and also many cases of stage IV gastric cancer diagnosed after postoperative pathologic exam. Although the prognosis of stage IV gastric cancer is very poor, this study was performed to find out the value of aggressive treatment by clinical analysis.

(Material and method) Analyzed retrospectively 150 patients diagnosed stage IV gastric cancer among 1376 patients who were underwent laparotomy for gastric cancer from January 1994 to December 2006.

(Result) Distribution of sex in 150 patients with stage IV gastric cancer who were underwent laparotomy was 104 men and 46 women. Mean age was 57.8 years old (range 28~93 years). 119 patients were performed subtotal gastrectomy or total gastrectomy and 31 patients were underwent explore laparotomy in total patients. Mean survival time of the patients performed gastrectomy and of the patients underwent explore laparotomy was 722 days (range 14~4559 days), 173 days (range 16~374 days) respectively, and there was statistical significance. When patients performed gastrectomy were classified to TNM stage, mean survival time of 33 patients with T4 was 534 days (range 17~3378 days) and mean survival time of 63 patients with N3 was 521 days (range 14~4190 days), but there was not statistical significance. 98 patients were taken chemotherapy and 52 patients were not, mean survival time were 792 days (range 36~4559 days), 243 days (range 14~2413 days) respectively, and there was statistical significance.

(Conclusion) If there is no evidence of distant metastasis in stage IV gastric cancer, we can expect improvement of survival rate by aggressive treatment including curative gastric resection with radical lymph node dissection and chemotherapy.

Key word : Stage IV, Gastric cancer, Gastrectomy