Journal of Gastric Cancer

  • 제11권1호
  • /
  • Pages.1-6
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  • 2011
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Recent Evolution of Surgical Treatment for Gastric Cancer in Korea

  • An, Ji-Yeong (Department of Surgery, Yonsei University College of Medicine) ;
  • Cheong, Jae-Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Hyung, Woo-Jin (Department of Surgery, Yonsei University College of Medicine) ;
  • Noh, Sung-Hoon (Department of Surgery, Yonsei University College of Medicine)
  • 투고 : 2011.02.28
  • 심사 : 2011.03.10
  • 발행 : 2011.03.31
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초록

Gastric cancer is the most common malignancy and the incidence is steadily increasing in Korea. The principal treatment modality for gastric cancer is surgical extirpation of tumor along with draining lymph nodes. Gastrectomy with D2 lymph node dissection has been well established as a standard of surgery and improved the survival of gastric cancer patients. Recently, technological advances are drastically reshaping the landscape of surgical treatment of gastric cancer. One of the most notable trends is that minimal access surgery becomes dominating the treatment of early stage diseases. For advanced diseases, the standard access surgery is considered a reference treatment. Although there is a pilot study underway to evaluate the feasibility of the application of minimal access surgery to advanced gastric cancer (AGC), the evidence for oncological safety is not yet provided sufficiently. Based on the recent randomized controlled trials, the extent of surgery for AGC has re-defined as para-aortic lymph node dissection dose not add any survival benefit while increasing surgery-related morbidities. In addition, it is now accepted as a standard operation omitting unnecessary procedures such as splenectomy and/or distal pancreatectomy for prophylactic lymph node dissection. Conceptual and technical innovation has contributed to decreasing morbidity and mortality without impairing oncological safety. All these recent advances in the field of gastric cancer surgery would be concluded in maximizing therapeutic index for gastric cancer while improving quality of life.

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참고문헌

  1. Jung KW, Park S, Kong HJ, Won YJ, Boo YK, Shin HR, et al. Cancer statistics in Korea: incidence, mortality and survival in 2006-2007. J Korean Med Sci 2010;25:1113-1121. https://doi.org/10.3346/jkms.2010.25.8.1113
  2. http://www.cancer.go.kr/cms/statics/Accessed February 27, 2011.
  3. The Information Committee of the Korean Gastric Cancer Association. 2004 Nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2007;7:47-54.
  4. Sim YK, Kim CY, Jeong YJ, Kim JH, Hwang Y, Yang DH. Changes of the clinicopathological characteristics and survival rates of gastric cancer with gastrectomy: 1990s vs early 2000s. J Korean Gastric Cancer Assoc 2009;9:200-206.
  5. Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy--Japan Clinical Oncology Group study 9501. J Clin Oncol 2004;22:2767-2773. https://doi.org/10.1200/JCO.2004.10.184
  6. Park DJ, Lee HJ, Kim HH, Yang HK, Lee KU, Choe KJ. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg 2005;92:1099-1102. https://doi.org/10.1002/bjs.4952
  7. Cuschieri A, Fayers P, Fielding J, Craven J, Bancewicz J, Joypaul V, et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group. Lancet 1996;347:995-999. https://doi.org/10.1016/S0140-6736(96)90144-0
  8. Bonenkamp JJ, Songun I, Hermans J, Sasako M, Welvaart K, Plukker JT, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995;345:745-748. https://doi.org/10.1016/S0140-6736(95)90637-1
  9. Chung IK, Lee JH, Lee SH, Kim SJ, Cho JY, Cho WY, et al. Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study. Gastrointest Endosc 2009;69:1228-1235. https://doi.org/10.1016/j.gie.2008.09.027
  10. Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000;3:219-225. https://doi.org/10.1007/PL00011720
  11. Park YD, Chung YJ, Chung HY, Yu W, Bae HI, Jeon SW, et al. Factors related to lymph node metastasis and the feasibility of endoscopic mucosal resection for treating poorly differentiated adenocarcinoma of the stomach. Endoscopy 2008;40:7-10. https://doi.org/10.1055/s-2007-966750
  12. Kim JH, Lee YC, Kim H, Song KH, Lee SK, Cheon JH, et al. Endoscopic resection for undifferentiated early gastric cancer. Gastrointest Endosc 2009;69:e1-9. https://doi.org/10.1016/j.gie.2008.10.040
  13. An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 2007;246:749-753. https://doi.org/10.1097/SLA.0b013e31811f3fb7
  14. Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, et al; Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group. Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale korean multicenter study. Ann Surg Oncol 2008;15:2692-2700. https://doi.org/10.1245/s10434-008-0075-z
  15. Song J, Lee HJ, Cho GS, Han SU, Kim MC, Ryu SW, et al; Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group. Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: a multicenter retrospective analysis of 1,417 patients. Ann Surg Oncol 2010;17:1777-1786. https://doi.org/10.1245/s10434-010-0932-4
  16. Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report--a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg 2010;251:417-420. https://doi.org/10.1097/SLA.0b013e3181cc8f6b
  17. Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH. Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 2009;23:1204-1211. https://doi.org/10.1007/s00464-009-0351-4
  18. Park do J, Lee HJ, Jung HC, Kim WH, Lee KU, Yang HK. Clinical outcome of pylorus-preserving gastrectomy in gastric cancer in comparison with conventional distal gastrectomy with Billroth I anastomosis. World J Surg 2008;32:1029-1036. https://doi.org/10.1007/s00268-007-9441-4
  19. An JY, Youn HG, Choi MG, Noh JH, Sohn TS, Kim S. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg 2008;196:587-591. https://doi.org/10.1016/j.amjsurg.2007.09.040
  20. Kong SH, Kim JW, Lee HJ, Kim WH, Lee KU, Yang HK. Reverse double-stapling end-to-end esophagogastrostomy in proximal gastrectomy. Dig Surg 2010;27:170-174. https://doi.org/10.1159/000264658
  21. Kitagawa Y, Fujii H, Kumai K, Kubota T, Otani Y, Saikawa Y, et al. Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management. J Surg Oncol 2005;90:147-151. https://doi.org/10.1002/jso.20220
  22. Lee JH, Hyung WJ, Noh SH. Comparison of gastric cancer surgery with versus without nasogastric decompression. Yonsei Med J 2002;43:451-456.
  23. Kim J, Lee J, Hyung WJ, Cheong JH, Chen J, Choi SH, et al. Gastric cancer surgery without drains: a prospective randomized trial. J Gastrointest Surg 2004;8:727-732. https://doi.org/10.1016/j.gassur.2004.05.018
  24. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma - 2nd English Edition - Gastric Cancer 1998;1:10-24.
  25. Cuschieri A, Weeden S, Fielding J, Bancewicz J, Craven J, Joypaul V, et al. Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer 1999;79:1522-1530. https://doi.org/10.1038/sj.bjc.6690243
  26. Schwarz RE, Smith DD. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial. J Clin Oncol 2005;23:5404-5405. https://doi.org/10.1200/JCO.2005.05.189
  27. Lee J, Kim W. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: analysis of consecutive 106 experiences. J Surg Oncol 2009;100:693-698. https://doi.org/10.1002/jso.21400
  28. Hur H, Jeon HM, Kim W. Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years' experience. J Surg Oncol 2008;98:515-519. https://doi.org/10.1002/jso.21155
  29. Lee KY, Noh SH, Hyung WJ, Lee JH, Lah KH, Choi SH, et al. Impact of splenectomy for lymph node dissection on longterm surgical outcome in gastric cancer. Ann Surg Oncol 2001;8:402-406. https://doi.org/10.1007/s10434-001-0402-0
  30. Oh SJ, Hyung WJ, Li C, Song J, Kang W, Rha SY, et al; Yonsei Gastric Cancer Clinic. The effect of spleen-preserving lymphadenectomy on surgical outcomes of locally advanced proximal gastric cancer. J Surg Oncol 2009;99:275-280. https://doi.org/10.1002/jso.21229
  31. Yu W, Choi GS, Chung HY. Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. Br J Surg 2006;93:559-563. https://doi.org/10.1002/bjs.5353
  32. Sasako M, Sano T, Yamamoto S, Kurokawa Y, Nashimoto A, Kurita A, et al; Japan Clinical Oncology Group. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med 2008;359:453-462. https://doi.org/10.1056/NEJMoa0707035
  33. Yonemura Y, Wu CC, Fukushima N, Honda I, Bandou E, Kawamura T, et al; East Asia Surgical Oncology Group. Operative morbidity and mortality after D2 and D4 extended dissection for advanced gastric cancer: a prospective randomized trial conducted by Asian surgeons. Hepatogastroenterology 2006;53:389-394.
  34. Yonemura Y, Wu CC, Fukushima N, Honda I, Bandou E, Kawamura T, et al; East Asia Surgical Oncology Group. Randomized clinical trial of D2 and extended paraaortic lymphadenectomy in patients with gastric cancer. Int J Clin Oncol 2008;13:132-137. https://doi.org/10.1007/s10147-007-0727-1
  35. Nakajima T. Gastric cancer treatment guidelines in Japan. Gastric Cancer 2002;5:1-5.
  36. Masuda TA, Sakaguchi Y, Toh Y, Aoki Y, Harimoto N, Taomoto J, et al. Clinical characteristics of gastric cancer with metastasis to the lymph node along the superior mesenteric vein (14v). Dig Surg 2008;25:351-358. https://doi.org/10.1159/000165382
  37. Lim JT, Yook JH, Jung O, Kim JH, Oh ST, Kim BS, et al. Indication of dissection of the 14v lymph node in advanced distal gastric cancer. J Korean Gastric Cancer Assoc 2006;6:154-160.

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  3. Safety and Efficacy of Fast-track Surgery in Laparoscopic Distal Gastrectomy for Gastric Cancer: A Randomized Clinical Trial vol.36, pp.12, 2011, https://doi.org/10.1007/s00268-012-1741-7
  4. Pathologic and Oncologic Outcomes in Locally Advanced Gastric Cancer with Neoadjuvant Chemotherapy or Chemoradiotherapy vol.54, pp.4, 2013, https://doi.org/10.3349/ymj.2013.54.4.888
  5. Expression of pyruvate dehydrogenase kinase-1 in gastric cancer as a potential therapeutic target vol.42, pp.1, 2011, https://doi.org/10.3892/ijo.2012.1687
  6. Efficacy of intraoperative gastroscopy for tumor localization in totally laparoscopic distal gastrectomy for cancer in the middle third of the stomach vol.27, pp.11, 2011, https://doi.org/10.1007/s00464-013-3042-0
  7. Problems faced by evidence-based medicine in evaluating lymphadenectomy for gastric cancer vol.20, pp.36, 2011, https://doi.org/10.3748/wjg.v20.i36.12883
  8. Long-Term Results of Laparoscopic Gastrectomy for Gastric Cancer: A Large-Scale Case-Control and Case-Matched Korean Multicenter Study vol.32, pp.7, 2011, https://doi.org/10.1200/jco.2013.48.8551
  9. Current Status and Future Prospect of Robotic Surgery in Korea vol.17, pp.4, 2011, https://doi.org/10.7602/jmis.2014.17.4.55
  10. Effects of stromal interacting molecule 1 gene silencing by short hairpin RNA on the biological behavior of human gastric cancer cells vol.12, pp.2, 2011, https://doi.org/10.3892/mmr.2015.3778
  11. External Validation of an Eastern Asian Nomogram for Survival Prediction After Gastric Cancer Surgery in a European Patient Cohort vol.94, pp.52, 2011, https://doi.org/10.1097/md.0000000000002406
  12. Adjuvant radiochemotherapy for gastric cancer: Should we use prognostic factors to select patients? vol.22, pp.3, 2011, https://doi.org/10.3748/wjg.v22.i3.1131
  13. Glucose metabolism in gastric cancer: The cutting-edge vol.22, pp.6, 2011, https://doi.org/10.3748/wjg.v22.i6.2046
  14. Relationships between gastrointestinal symptoms, uncertainty, and perceived recovery in patients with gastric cancer after gastrectomy vol.18, pp.1, 2011, https://doi.org/10.1111/nhs.12219
  15. A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer vol.17, pp.3, 2011, https://doi.org/10.5230/jgc.2017.17.e32
  16. Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer: Is there still a role for radiation therapy? vol.10, pp.9, 2018, https://doi.org/10.4251/wjgo.v10.i9.271
  17. The Impact of Preoperative Low Body Mass Index on Postoperative Complications and Long-term Survival Outcomes in Gastric Cancer Patients vol.18, pp.3, 2011, https://doi.org/10.5230/jgc.2018.18.e30
  18. Role of preoperative endoscopic clipping in laparoscopic distal gastrectomy for early gastric cancer vol.97, pp.45, 2011, https://doi.org/10.1097/md.0000000000013165
  19. Tumor localization using radio-frequency identification clip marker: experimental results of an ex vivo porcine model vol.33, pp.5, 2011, https://doi.org/10.1007/s00464-018-6423-6
  20. Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer vol.24, pp.2, 2011, https://doi.org/10.7602/jmis.2021.24.2.76