• Journal of Gastric Cancer
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• 제10권3호
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• pp.111-117
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• 2010

Purpose: The aim of this study was to determine the prognostic factors and the significance of metastatectomy for Krukenberg's tumors of gastric origin.Materials and Methods: Among the patient who underwent gastric surgery from 1992 through 2005, 90 female patients with Krukenberg's tumors of gastric origin were identified. We retrospectively reviewed the clinicopathologic characteristics, prognostic factors, and treatments for primary gastric cancer. We also investigated the prognostic risk factors for the onset of metachronous Krukenberg's tumors and the survival time of patients who underwent an operation for metachronous Krukenberg's tumors. Results: The presence of a synchronous Krukenberg's tumor (mean survival time=17.6 months, P<0.01), peritoneal seeding (14.5 months, P<0.01), and non-curative resection (15.1 months, P<0.01), were statistically significant prognostic factors for survival time in female patients with gastric cancer. The stage of primary gastric cancer (P=0.049) and lymph node metastasis (P=0.011) were statistically significant risk factors for recurrence time of a metachronous Krukenberg's tumor. In the metachronous Krukenberg's tumor group (n=53), the mean survival time of the metastatectomy group (n=46, 43.2 months, P=0.012) was longer than that in the chemotherapy or conservative treatment groups (n=7 and 24 months, respectively). Metastatectomy, presense or abscence of residual tumor and extent of residual tumor were significant prognostic factors for survival time in female patients with metachronous Krukenberg's tumor of gastric origin. Conclusions: A close observation and evaluation with ultrasound or computed tomography is necessary in female patients with advanced gastric cancer to detect a metachronous Krukenberg's tumor as soon as possible. The surgeon must operate more aggressively in patients with metachronous Krukenberg's tumors.

• Journal of Gastric Cancer
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• 제17권1호
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• pp.93-97
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• 2017

An 84-year-old man was diagnosed with two synchronous adenocarcinomas, a Borrmann type IV advanced gastric adenocarcinoma in his antrum and a well-differentiated Borrmann type I carcinoma on the anterior wall of the higher body of his stomach. Pre-operatively, computed tomography of the abdomen revealed the presence of advanced gastric cancer with peri-gastric and para-aortic lymph node (LN) metastasis. He planned for palliative total gastrectomy owing to the risk of obstruction by the antral lesion. We performed a frozen biopsy of a para-aortic LN during surgery and found that the origin of the para-aortic LN metastasis was from undiagnosed prostate cancer. Thus, we performed radical total gastrectomy and D2 LN dissection. Post-operatively, his total prostate-specific antigen levels were high (227 ng/mL) and he was discharged 8 days after surgery without any complications.

• Journal of Gastric Cancer
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• 제8권4호
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• pp.198-203
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• 2008

목적: 다발성 조기위암은 전체 조기위암 중 4.5~11.7%를 차지한다. 본 연구는 다발성 조기위암의 임상병리학적 특징을 조사 분석하여 그 의의를 알아보고 치료방침의 수립에 도움이 되고자 시행하였다. 대상 및 방법: 1994년 1월부터 2004년 12월까지 11년간 연세대학교 의과대학 외과학교실에서 위선암으로 진단받고 근치적 위절제술을 시행한 2,281예의 조기위앙을 대상으로 의무기록을 후향적으로 조사 분석하였다. 결과: 다발성 조기위암은 총 91예(4.0%)였으며 2개의 병변이 81예, 3개가 9예, 4개가 1예였다. 총 102예의 보조병변 중 64예(62.7%)는 크기가 10 mm 이하였으며 83예(81.4%)는 주병변과 같은 부위에 위치하였다. 가장 흔한 조직학적 분류는 분화형으로 52예(57.1%)였다. 점막암은 49예(53.8%)였으며 점막하층암은 42예(46.2%)였고 림프절 전이는 6예(6.6%)에서 발견되었다. 단발성 조기위암과 비교하였 때 전체 생존율에서 통계학적으로 유의한 차이가 없었다. 결론: 다발성 조기위암은 단발성 조기위암과 임상병리학적으로 매우 유사하며 생존율에서도 차이가 없었다. 그러므로 다발성 오기위암의 치료에 있어서 일반적인 조기위암의 치료지침에 준한 방법을 적용할 수 있으며, 조기위암의 수술 전후 잔위에 보조병변을 남기지 않기 위하여 세심한 주의가 필요하다.