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Prognostic Factors in Stage IB Gastric Cancer after Surgical Resection

Journal of Gastric Cancer 2020년 20권 3호 p.328 ~ 336
Yu Byung-Hyuk, 박지연, 박기범, 권오경, 이승수, 정호영,
소속 상세정보
 ( Yu Byung-Hyuk ) - Kyungpook National University Chilgok Hospital Gastric Cancer Center
박지연 ( Park Ji-Yeon ) - Kyungpook National University Chilgok Hospital Gastric Cancer Center
박기범 ( Park Ki-Bum ) - Kyungpook National University Chilgok Hospital Gastric Cancer Center
권오경 ( Kwon Oh-Kyoung ) - Kyungpook National University Chilgok Hospital Gastric Cancer Center
이승수 ( Lee Seung-Soo ) - Kyungpook National University Hospital Department of Surgery
정호영 ( Chung Ho-Young ) - Kyungpook National University Hospital Department of Surgery

Abstract


Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery.

Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival.

Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4?56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264?11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157?12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105?11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI.

Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.

키워드

Stomach neoplasm; Prognosis; Gastrectomy; Lymphatic metastasis

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