To evaluate survival rate and prognostic facotrs(especially presentation of P-glycoprotein) in gatric adenocarcinoma, 296 cases were reviewed who were treated surgically at the department of Surgery, Wonkwang university hospital, from January
1982
to
July 1992. Stage was determined by AJCC classification(1992). Immunohistochemical study of P-glycoprotein was done with LSAB kit and anti-P170 Glycoprotein monoclonal antibody(Monosan(r)) in stage III group who were treated
chemotherpy±immunotherapy
postoperatively during more than 4 months. P-glycorprotein positive was defined when the tumor cells more than 10% showed red dot in the cytoplasm. Statistical analyses carried out using BMDP and cumulative survival rate was calculated using the
Kaplan-Meier approach.
1) Sex ratio was3.1 : 1 and peak age incidence was in 6th decade(118 cases, 39.9%).
2) Distribution of stage and 5 year sarvival rate: stage Ia 39 cases(13.2%) 30.0%. Iv 78 cases(26.4%) 5.1%.
Following factors were analysed with 5 year survival rate of 179 cases in stage Ib, II, & III.
1) Depth of invasion; T2(n=65) 74.2%, T3(n=111) 49.1%, T4(n=3) 0% (P<0.001. Ratio of Risk 2.006)
2) Lymph node metastasis; N0 (n=82) 68.9%, N1(n=52) 57.6%, (N2(n=45) 35.7% (P<0.001, RR 1.2261)
3) Dissection extent of lymph node; D1(n=55) 46.6%, ≥D2(n=124) 624%(P<0.05, RR 0.4709)
4) Age, sex, location of tumor, size of tumor, gross form, histologic type, and type of gastric resection were not significant statistically.
5) Chemotherapy(FAM8week cycle or oral 5Fu+MMC)±immunotherapy (PSK or OK-432) in stage III; done over 4 months(n=39) 41.5%, not done (n=27) 45.3% (p>0.05)
6) Presentation of P-glycoprotein; positive(n=22) 49.2%, negative (n=16) 25.0% (p>0.05)
This study showed that depth of invasion, lymph node metastasis, and dissection extent of lymph nodes were significant in gastric cancer prognosis, but presentation of P-glycoprotein in primary gastric adenocarcinoma was not.
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