Risk Factors of Microscopic Invasion in Early Gastric Cancer

최종호; 서윤석; 박신후; 공성호; 이혁준; 김우호; 양한광

doi:https://doi.org/10.5230/jgc.2017.17.e37

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자료유형: 학술저널

저자정보: 최종호 (서울대학교) 서윤석 (서울대학교병원) 박신후 (서울대학교병원) 공성호 (서울대학교병원) 이혁준 (서울대학교) 김우호 (서울대학교) 양한광 (서울대학교)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제17권 제4호

발행연도: 2017.12

수록면: 331 - 341 (11page)

DOI: https://doi.org/10.5230/jgc.2017.17.e37

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Purpose: This study aimed to evaluate the clinical significance of microscopic invasion to determine the adequate resection margin in early gastric cancer (EGC). Materials and Methods: A retrospective review was performed that included patients who underwent gastrectomy for clinical early gastric cancer (cEGC) at Seoul National University Hospital between January 2007 and December 2010. After subtracting the microscopic resection margin from the gross resection margin for each proximal or distal resection margin, microscopic invasion was represented by the larger value. Microscopic invasion and its risk factors were analyzed according to the clinicopathologic characteristics. Results: In total, 861 patients were enrolled in the study. Microscopic invasion of cEGC was 6.0±12.8 mm, and the proportion of patients with microscopic invasion ≥0 mm was 78.4%. In the risk group, tumor location, pT stage, and differentiation did not significantly discriminate the presence of microscopic invasion. The microscopic invasion of EGC-IIb was 13.9±16.8 mm, which was significantly greater than that of EGC-I. No linear correlation was observed between the overall tumor size and microscopic invasion (R=0.030). The independent risk factors for microscopic invasion ≥20 mm were EGC-IIb vs. EGC-I/IIa/IIc/III (odds ratio [OR], 3.103; 95% confidence interval [CI], 1.533?6.282; P=0.002) and male vs. female sex (OR, 1.655; 95% CI, 1.012?2.705; P=0.045). Conclusions: Male sex and EGC-IIb were independent risk factors for microscopic invasion ≥20 mm. Examination of intraoperative frozen sections is highly recommended to avoid resection margin involvement, especially in cases of EGC-IIb.

#Stomach neoplasm #Risk factors

참고문헌 (3)

참고문헌 신청

Raziee HR / 2012 / Systematic review of the predictors of positive margins in gastric cancer surgery and the effect on survival / Gastric Cancer 15(Suppl 1):S116~S124

Ji Hyun Lee / 2010 / Which Is the Optimal Extent of Resection in Middle Third Gastric Cancer between Total Gastrectomy and Subtotal Gastrectomy? / Journal of Gastric Cancer 10(4):226~233

엄방울 / 2016 / Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014 / Journal of Gastric Cancer 16(3):131~140

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