Choi Won Hyuk, Kim Sungsoo, Shen Jiayun, Cheong Jae Ho, Hyung Woo Jin, Kim Yong Il, Choi Seung Ho, Noh Sung Hoon, Park Chan Il
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
J Surg Oncol. 2007 Jun 1;95(7):540-5. doi: 10.1002/jso.20734.
The grouping of patients who have a poor prognosis is important in determining a treatment strategy. The aim of this study was to investigate the clinicopathologic features and prognosis in patients with perinodal extension, with a focus on the difference of survival between homogenous groups.
This study included a total of 1,092 patients who underwent curative gastrectomy for gastric adenocarcinoma from 1997 to 2004 at the Department of Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine.
One hundred sixty-one patients had perinodal extension. The incidence of perinodal extension was positively correlated for T and N stages. Perinodal extension was identified as an independent prognostic factor and had more influence on survival than T and N stages. Patients who had nodal metastasis without serosal exposure and who had serosal exposure without nodal metastasis were selected as homogenous groups, and there was no difference of survival between these groups. However, when the nodal metastasis group was subdivided according to the perinodal extension, perinodal extension subgroup had significant poorer prognosis than no perinodal extension subgroup.
The perinodal extension was the most important independent prognostic factor in gastric cancer, and should be included in the TNM gastric cancer staging system.
对预后不良的患者进行分组对于确定治疗策略很重要。本研究的目的是调查伴有结周扩展的患者的临床病理特征和预后，重点关注同质组之间的生存差异。
本研究共纳入1997年至2004年在延世大学医学院江东Severance医院外科接受胃癌根治性胃切除术的1092例患者。
161例患者有结周扩展。结周扩展的发生率与T和N分期呈正相关。结周扩展被确定为独立的预后因素，对生存的影响比T和N分期更大。将无浆膜侵犯的淋巴结转移患者和无淋巴结转移的浆膜侵犯患者选为同质组，这两组之间的生存无差异。然而，当根据结周扩展对淋巴结转移组进行细分时，结周扩展亚组的预后明显比无结周扩展亚组差。
结周扩展是胃癌最重要的独立预后因素，应纳入TNM胃癌分期系统。
