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자료유형
학술저널
저자정보
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제41권 제1호
발행연도
2009.1
수록면
19 - 23 (5page)

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Purpose ; The optimal chemotherapeutic strategy for gastric cancer patients has not been determined, especially with respect to stage and the curability of gastric cancer. The aim of this study was to evaluate the results of adjuvant chemotherapy on stage Ⅳ(T4N1-3M0 and T1-3N3M0) gastric cancer after curative gastrectomy between a chemotherapy (CTX) group and non-chemotherapy (non-CTX) group. Materials and Methods ; Among 1,760 patients who underwent gastric surgery by 1 surgeon in a single institution, 162 stage Ⅳgastric cancer patients with curative gastrectomy were analyzed retrospectively, excluding patients with TanyNanyM1. One hundred twenty-five patients who received different chemotherapeutic regimens were compared to 37 patients who did not receive chemotherapy for reasons of old age or according to their expressed desire. Results ; The clinicopathologic factors which showed a clinically significant difference between the two groups were age and histology, which were not associated with patient survival. The CTX group was younger, and had a larger proportion of undifferentiated gastric cancers than the non-CTX group. The mode of treatment failure revealed no significant difference between the CTX and non-CTX groups. The 1, 3, and 5-year disease-free survival and the 1, 3, and 5-year disease-specific survival of the CTX group were 63.9%, 38.4%, and 32.0%, and 85.4%, 52.3%, and 39.6%, respectively, which were more favorable than the non-CTX group (p=0.015 and p=0.001, respectively). Postoperative adjuvant CTX was an independent risk factor for disease-specific survival of stage Ⅳ(T4N1-3M0 and T1-3N3M0) gastric cancer patients after curative gastrectomy by multivariate analysis (odds ratio=2.153; 95% confidence interval=1.349-3.435; p=0.001). Conclusions ; Adjuvant CTX may be associated with survival benefit for younger patients with stage Ⅳ (T4N1-3M0 and T1-3N3M0) gastric cancer with undifferentiated histology after curative gastrectomy. A randomized controlled trial to reveal the effect of stage-specific adjuvant chemotherapy should be conducted.
#Adjuvant chemotherapy #Stage Ⅳgastric cancer #Curative gastrectomy #Survival

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참고문헌 (22)

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Aurello P / 2007 / Classification of lymph node metastases from gastric cancer: comparison between N-site and Nnumber systems. Our experience and review of the literature / A google schola Bajetta E / 2002 / Adjuvant chemotherapy in gastric cancer: 5-year results of a randomised study by the Italian Trials in Medical Oncology (ITMO) Group / Ann Oncol 13 : 299 google schola Benson AB 3rd / 2004 / American society of clinical oncology recommendations on adjuvant chemotherapy for stage II colon cancer / J Clin Oncol 22 : 3408 ~ 3419 google schola Cunningham D / 2006 / Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer / N Engl J Med 355 : 11 ~ 20 google schola Di Costanzo F / 2008 / Adjuvant chemotherapy in completely resected gastric cancer: a randomized phase III trial conducted by GOIRC / J Natl Cancer Inst 100 : 388 ~ 398 google schola

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