<P><B>Purpose</B></P><P>Depth of wall invasion is an important prognostic factor in patients with gastric cancer, whereas the prognostic significance of intraoperative macroscopic serosal invasion (mSE) findings remain un...
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https://www.riss.kr/link?id=A107503679
2016
-
KCI등재,SCOPUS,SCIE
학술저널
250-256(7쪽)
0
상세조회0
다운로드다국어 초록 (Multilingual Abstract)
<P><B>Purpose</B></P><P>Depth of wall invasion is an important prognostic factor in patients with gastric cancer, whereas the prognostic significance of intraoperative macroscopic serosal invasion (mSE) findings remain un...
<P><B>Purpose</B></P><P>Depth of wall invasion is an important prognostic factor in patients with gastric cancer, whereas the prognostic significance of intraoperative macroscopic serosal invasion (mSE) findings remain unclear when they show a discrepancy in pathologic findings. This study, therefore, assessed the prognostic significance of mSE.</P><P><B>Methods</B></P><P>Data from cohort of 2,835 patients with resectable gastric cancer who underwent surgery between 1990 and 2010 were retrospectively reviewed.</P><P><B>Results</B></P><P>The overall accuracy of mSE and pathologic results was 83.4%. The accuracy of mSE was 75.5% in pT2. On the other hand, the accuracy of pT3 dropped to 24.5%. According to mSE findings (+/–), the 5-year disease-specific survival (DSS) rate differed significantly in patients with pT2 (+; 74.2% <I>vs.</I> –; 92.0%), pT3 (+; 76.7% <I>vs.</I> –; 91.8%) and pT4a (+; 51.3% <I>vs.</I> –; 72.8%) (P < 0.001 each), but not in patients with T1 tumor. Multivariate analysis showed that mSE findings (hazard ratio [HR], 2.275; 95% confidence interval [CI], 1.148–4.509), tumor depth (HR, 6.894; 95% CI, 2.325–20.437), nodal status (HR, 5.206; 95% CI, 2.298–11.791), distant metastasis (HR, 2.881; 95% CI, 1.388–6.209), radical resection (HR, 2.002; 95% CI, 1.017–3.940), and lymphatic invasion (HR, 2.713; 95% CI, 1.424–5.167) were independent predictors of 5-year DSS rate.</P><P><B>Conclusion</B></P><P>We observed considerable discrepancies between macroscopic and pathologic diagnosis of serosal invasion. However, macroscopic diagnosis of serosal invasion was independently prognostic of 5-year DSS. It suggests that because the pathologic results could not be perfect and the local inflammatory change with mSE(+) could affect survival, a combination of mSE(+/–) and pathologic depth may be predictive of prognosis in patients with gastric cancer.</P>
The rat choledochojejunostomy model for microsurgical training