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KMID : 0371320100790030196
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Journal of the Korean Surgical Society
2010 Volume.79 No. 3 p.196 ~ p.201
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Resection A Surgery: An Exclusion Criterion of Adjuvant Treatment for Gastric Cancer
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Yu Wan-Sik
Chung Ho-Young
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Abstract
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Purpose: We evaluated the clinical implication of Resection A surgery retrospectively to identify whether quality of surgery can be used as a selection factor for adjuvant therapy in patients with gastric cancer.
Methods: Prognosis of 902 patients with gastric cancer who underwent Resection A surgery was evaluated.
Results: Among all discharged patients, 77 patients (8.5%) died of recurrent disease, 55 patients (6.1%) died without recurrent disease. Five-year survival rate of all discharged patients was 91.6% and 10-year survival rate 87.1%. Statistically significant prognostic factors were depth of invasion (P＜0.001), lymph node metastasis (P＜ 0.001), stage (P＜0.001), tumor location (P=0.036) and size (P=0.001), extent of gastric resection (P＜0.001), and chemotherapy (P＜0.001) on univariate analyses. However, depth of invasion (P=0.001), lymph node metastasis (P＜0.001), and total gastrectomy (P＜0.001) emerged as statistically significant poor prognostic factor on a multivariate analysis. Adjuvant chemotherapy did not increase the survival rate of patients after Resection A surgery, even in patients with stage II disease.
Conclusion: In selecting the patients for adjuvant therapy, both the stage of gastric cancer and the quality of surgery should be considered.
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KEYWORD
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Stomach neoplasm, Quality of surgery, Adjuvant chemotherapy
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