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Effectiveness of Gastrectomy in Stage Ⅳ Gastric Cancer with Hepatic Metastasis

Other Title
간전이의 제4기 위암에서 위절제술의 유용성
Authors
육, 정환; 권, 성준; 김, 병기; 김, 병식; 김, 성; 노, 승무; 목, 영재; 박, 경규; 박, 병주; 박, 승만; 박, 조현; 방, 호윤; 배, 재문; 송, 영진; 양, 두현; 양, 대현; 오, 성태; 윤, 효영; 이, 무송; 이, 종인; 조, 용관; 최, 동욱; 한, 상욱
Citation
Taehan Am Hakhoe chi, 31(3):441-447, 1999
Journal Title
Taehan Am Hakhoe chi; Journal of Korean Cancer Association; 대한암학회지
ISSN
0496-6872
Abstract
Purpose : The prognosis for patients with stage Ⅳ gastric cancer is very poor, However, recently,

some studies have reported benefits from a gastric resection for metastatic gastric cancer. This

clinical study was performed to evaluate the effectiveness of a noncurative gastrectomy in treating

stage Ⅳ gastric cancer with hepatic metastasis.

Materials and Methods : A retrospective analysis was performed on 98 gastric cancer patients

who had undergone gastric resection, in spite of hepatic metastasis, between January 1990 and

December 1996 at the Department of Surgery in 11 General Hospitals in Korea.

Results : The average age was 58 years old, and the male-to-female ratio was 69 : 29. The

laboratory tests were unable to predict hepatic metastasis. In 54 cases, hepatic metastasis was not

identified before the surgery. The most common location of gastric cancer was antrum (72 cases).

The most common gross type was Borrmann type Ⅲ (78 cases). The serosa-exposed cases were

80. The peritoneal seeding was combined in 17 cases. A total gastrectomy was performed in 18

cases and a distal gastrectomy in 80. Lymph-node dissection was performed in 23 D1, and 51 D2

cases. Hepatic resection was performed in 36 cases. The frequent histologic types were moderately

differentiated and poorly differentiated tubular adenocarcinoma. Postoperative adjuvant chemotherapy

was done in 70 cases. The complication rate (7%) was low. The median survival time was 15

months, with mean survival time of 18 months. The 2-year and 3-year survival rates were 23%,

and 7%, respectively. In the univariate analysis, good survival was closely related to limitation of

hepatic metastasis to one lobe, a few metastases to both lobes, negativity of peritoneal seeding and

lymph node dissection more than D2 (P<0.05).

Conclusions : An aggressive gastric resection for stage Ⅳ gastric cancer with hepatic metastasis

might be beneficial in lengthening the survival period. A prospective study is needed, especially one

with an exact evaluation and analysis of the quality of life between the gastrectomy and

nonresection groups.
Keywords
hepatic metastasisGastrectomySurvival time
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Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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