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KMID : 0360319890210010093
Journal of Korean Cancer Research Association
1989 Volume.21 No. 1 p.93 ~ p.100
Clinical Evaluation of Total Gastrectomy and Extended Total Gastrectomy for Gastric Cancer



Abstract
During 16 years from Jan. 1970 to Dec. 1986, total gastrectomy and extended total gastrectomy were performed in 566 patients.
The results are as follows:
1) Gastrectomy was performed in 2891 out of 3791 patients (76%) who underwent operation.
2) Total gastrectomy and extended total gastrectomy were performed in 566 patients (19%) of them.
3) The most frequent site of primary gastric cancer was the body (40.5%), followed by the cardia and fundus (24.4%), diffuse infiltration of gastric wall (18.1%) and antrum (17.0%).
4) In the cases of advanced carcinoma, the most common Borrmann type was Type ¥² (55.8%), followed by Type IV (18.1%), Type ¥± (17.0%) and Type ¥° (3.4%).
5) Early gastric cancer was 26 cases (5.7%).
6) In the pathologic findings, the most common type was adenocarcinoma (68.9%), followed by mucinous cell (9.7%), signet ring cell (8.6%) and undifferentiated carcinoma (5.7%).
7) In the staging of cancer according to TNM postsurgical-pathologic stage group, stage I was 4. 4%, stage ¥± 17.4%, stage ¥² 78.2%.
8) In the extended total gastrectomy, partial hepatectomy was performed in 10 cases (8.4%) and transverse colectomy was performed in 10 cases (8.4%) in addition to pancreaticosplenectomy.
9) Overall operative mortality was 3.8% and no significant difference of operative mortality was found between total and extended total gastrectomy.
10) The expected 5 YSR, according to Cohort life table, was 45% in total gastrectomy and 24% in extended total gastrectomy. In the total gastrectomy patients, 5 YSR of stage ¥° , ¥±, ¥² were 100%, 68% and 36%, respectively. In the extended total gastrectomy patients, 5 YSR of stage ¥± and ¥² were 48% and 16%, respectively.
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