PURPOSE: The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients. MATERIALS AND METHODS: We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients. RESULTS: The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male. CONCLUSION: In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.
Female* ; Humans ; Laparotomy ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: The New Bethesda System terminology has opened a series of problems about the atypical squamous cells of undetermined significance and low grade squamous intraepithelial lesion categories, particularly on their follow up. METHODS: We observe 12300 Pap smear examination, from jan 1995 to Dec 1999, in the Health promotion Center in a university hospital. Subjects were defined a the Health Promotion Center in a university hospital by electrical record and chart review. RESULTS: We find 48 cases of ASCUS and 33 cases of LSIL. When it is followed up by Pap smear, 34 cases of ASCUS are confirmed normal 19 cases(55.9%), benign cellular change 6 cases(17.6%), ASCUS 5 cases(14.7%), HSIL 4 cases(11.8%) and 27 cases of LSIL are confirmed normal 11 cases(40.7%), benign cellular change 3 cases(11.1%), ASCUS 3 cases(11.1%), LSIL 8 cases(29.6%), HSIL 2 cases(7.4%). 14 cases of ASCUS and 23 cases of LSIL are diagnosed by biopsy. Hostologic results of 14 cases of ASCUS are confirmed cervicitis 10 cases(71.4%), Moderate dysplasia 2 cases(14.3%), carcinoma in sute 2 cases(14.3%) and histologic results of 23 cases of LSIL are confirmed cervicitis 15 cases(65.2%), mild dysplasia 3 cases(13%), moderated dysplasia 3 cases(13%), sever dysplasia 1 cases(4.3%), carcinoma in situ 1 case(4.3%). Pap smear only was used for follow-up at family medicine clinic and 14 cases(29.2%), 4 cases(12.1%) are follow-up loss. CONCLUSION: After it is diagnosed ASCUS or LSIL Lesion of Pap smear in healthy care visitors, Follw-up loss is high in only follow-up Pap smear examination and follow-up results are presented more we severe lesions. To reduce follow-up loss, aggressive diagnosis and managements may be needed more than Pap smear follow-up examination.
Biopsy ; Carcinoma in Situ ; Diagnosis ; Follow-Up Studies* ; Health Promotion ; Humans ; Uterine Cervicitis

PURPOSE: We purpose of this retrospective study is to evaluate the role of pancreaticoduadenectomy (PD) in gastric cancer which invades neighboring organs. MATERIALS AND METHODS: We analysed 28 patients with locally advanced gastric cancer which invaded to pancreas and/or duodenum who received surgical resection from Jan. 1989 to Dec. 1996. Patients were divided into two groups: Group A (n=12) who received PD and Group B (n=16) who received gastrectomy only. Indication of PD in group A is locally advanced gastric cancer which invaded to pancreas and/or duodenum but had no evidence of widespread nodal involvement, extended hepatic metastasis, or peritoneal dissemination. RESULTS: The operation time, amount of blood loss during operation, and postoperative hospital stay were greater in group A than in group B. Operative mortality was found in 1 case in group B but none in group A. Postoperative complications were similar in both groups. Four patients had liver metastases in both group during follow up period, whereas 2 and 4 patients had disseminated peritoneal seeding in group A and B, respectively. When survival rates were compared, Group A shows better survival than Group B (p= 0.043). CONCLUSION: These results suggest that PD is a rational and safe method for treatment of gastric cancer infiltrating into pancreatic head and/or duodenum.
Duodenum ; Follow-Up Studies ; Gastrectomy ; Head ; Humans ; Length of Stay ; Liver ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy* ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

We report a case of advanced gastric cancer with Virchow's node and lung metastasis that responded remarkably to preoperative chemotherapy. A 47-year-old female patient was diagnosed as having incurable advanced gastric cancer with Virchow's node and multiple lung metastasis. Preoperative chemotherapy with Taxotere, CDDP and 5FU was carried out. After four courses of the regimen, the Virchow's node and the lung metastasis had disappeared, and a marked reduction of the gastric lesion was observed on the CT scan. Consequently, the patient underwent a total gastrectomy with D2 lymph node dissection. On histopathological examination, cancer cells were found to have infiltrated up to the muscle layer of the gastric wall, and 42 out of 60 resected lymph nodes were found to be metastatic. The patient received another two courses of chemotherapy after the operation
Drug Therapy* ; Female ; Fluorouracil* ; Gastrectomy ; Humans ; Lung* ; Lymph Node Excision ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Stomach Neoplasms* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study is to analyze the clinicopathologic characteristics of gastric cancer patients and to evaluate the survival and prognostic factors and effect of immunochemosurgery for gastric cancer patients. MATENRIALS AND METHODS: The clinicopathologic characteristics were analyzed for 12,277 consecutive patients who underwent operation for gastric cancer from 1970 to 1999. We also evaluated the survival and prognostic factors for 9,262 consecutive patients from 1981 to 1996. The prognostic significance of treatment modality [surgery alone, surgery +chemotherapy, surgery+immunotherapy+chemotherapy (immunochemosurgery)] were evaluated in stage III gastric cancer. RESULTS: The 5-year survival rate (5-YSR) of overall patients was 55.8%, and that of patients who received curative resection was 64.8%. The 5-YSRs according to TNM stage were 92.9% for Ia, 84.2% for Ib, 69.3% for II, 45.8% for IIIa, 29.6% for IIIb and 9.2% for IV. Regarding adjuvant treatment modality, significant survival difference was observed in stage III patients. The 5-year survival rates were 44.8% for immunochemosurgery group, 36.8% for surgery+chemotherapy group and 27.2% for surgery alone group. Curative resection, depth of invasion and lymph node metastasis were the most significant prognostic factors in gastric cancer. CONCLUSION: Consequently, early detection and curative resection with radical lymph node dissection, followed by immunochemotherapy especially in patients with stage III gastric cancer should be recommended as a standard treatment principle for patients with gastric cancer.
Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms ; Survival Rate

Ginseng has been used as a herb medicine and a vital-additive drug for a long time, and recently its compositions and its pharmacologic actions have been studied scientifically. Particularly, since the initial reports suggesting that ginseng has an anticancer effect, there have been many other studies of this anticancer effect and its mechanisms. The anticancer effect of ginseng is explainable by two mechanisms: the direct cancer-cell-killing effect and reinforcement of the immune function of the host. The authors performed long-term administration of ginseng to patients with gastric cancer who had undergone curative surgery, observed the subjective symptoms, immune status, and nutritional status, and thereby analyzed the clinical anticancer effect of ginseng. The authors randomly selected 39 patients from among the patients with curative operations for gastric cancer. We divided the patients into two groups: 20 patients formed the study group and were administered red ginseng powder with a dose of 5400 mg per day in the form of capsules for two years postoperatively, and 19 patients formed the control group on which only follow-up was done. All the patients received postoperative adjuvant immunochemotherapy. The authors compared the preoperative and postoperative changes in appetite, the body weight to height ratio, the triceps skinfold thickness, the serum protein, the albumin and transferrin levels, the percentage of lymphocytes and the T-cell percentage in peripheral blood to examine the effect of ginseng on the subjective symptoms, as well as on the immune and the nutritional status. Although our data does not show that the long-term administration of ginseng to gastric cancer patients with curative resections improved the nutritional status, it does suggest that it improved the patients' subjective symptoms and immune functions and prevented postoperative recurrences.
Appetite ; Body Weight ; Capsules ; Follow-Up Studies ; Humans ; Lymphocytes ; Nutritional Status* ; Panax* ; Pharmacologic Actions ; Recurrence ; Skinfold Thickness ; Stomach Neoplasms ; T-Lymphocytes ; Transferrin

Growth factor receptors play critical roles in the regulation of normal growth and developement. Some of these molecules have been implicated in the neoplastic process as well. In this study, We examined the expression of the EGF receptor gene family in gastric carcinoma by Ribonuclease protection assay and investigated the relationship between the expression of using a mRNA and clinicopathologic parameters. Expression of EGFR mRNA was found in 34 of 59 cases (57.6%), expression of c-erbB-2 mRNA was found in 27 of 57 cases (64.9%), expression of c-erbB-3 mRNA was found in 47 of 60 cases (78.3%), and expression of c-erbB-4 mRNA was found in 39 of 59 cases (66.1%). The expression of EGFR was correlated with the size of the tumor. The expression of c-erbB-2 was correlated with the presence of endolymphatic tumor emboli, Ming's classification, and lymph node matastasis. The expression of c-erbB-3 was correlated with the macroscopic type. Coexpression of c-erbB-2 and c-erbB-3 was correlated with age. These results suggest that the production of the EGF receptor gene family by various tumor cells it may play an important role in the cellular function. Therefore, further studies are currently being carried out to clarify the role of these oncogenes in tumor behavior and gastric carcinogenesis.
Carcinogenesis ; Classification ; Epidermal Growth Factor* ; Humans ; Lymph Nodes ; Oncogenes ; Receptor, Epidermal Growth Factor* ; Receptors, Growth Factor ; Ribonucleases ; RNA, Messenger ; Stomach Neoplasms*

PURPOSE: Despite the decreasing incidence of primary gastric cancer, the incidence of gastric cancer in the remnant stomach has been increasing. This study evaluated the clinicopathologic features and prognosis of gastric cancer in the remnant stomach. METHODS AND MATERIALS: The clinicopathologic features and prognosis of 31 cases of gastric cancers in the remnant stomach were evaluated retrospectively. 19 patients among them underwent partial gastrectomy for benign gastroduodenal disease (Group I), while 12 patients for malignant disease (Group II) which were detected at least 5 years after initial surgery and the clinicopathologic features and survival curves of two groups were compared. The clinicopathologic features evaluated included age, sex, interval between operations, type of operation, location of tumor, tumor size, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and Lauren classification. RESULTS: The median age was 59 years, 28 patients (90.3%) were male and median time interval between operations was 15 years. Group I gastric remnant cancers were detected late after initial gastrectomy and have a significant tendency toward lymph node metastasis. Resection was carried out in 25 patients (81.0%) in which 22 patient (71.0%) underwent resections with curative intent. The overall 5 year survival rate was 45.5% and no significant difference was observed between the survival curves for patients with group I and group II. Depth of invasion, lymph node metastasis, distant metastasis, tumor size and curability of operation have prognostic significance in univariate analysis and multivariate analysis performed with above 5 factors has revealed that depth of invasion is the only independent prognostic factor. CONCLUSIONS: Both groups are similar in survival rate and clinicopathologic characteristics except time interval between operations and lymph node metastasis. Early detection by periodic endoscopic follow-up and radical resection is a reasonable policy as a treatment of gastric remnant cancer.
Classification ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Humans ; Incidence ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis* ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: The purpose of this report is to clarify the clinicopathologic features, survival rates and prognostic factors of gastric cancers in young age group. MATERIALS AND METHODS: We reviewed 133 patients with gastric cancer under 30 years of age who underwent surgery from January 1986 to December 1995 at the Department of Surgery, Seoul National University Hospital. We have analyzed the sex, age, Borrmann type, histologic differentiation, Lauren classification, depth of invasion, lymph node metastasis, distant metastasis, location of tumor, size of tumor, curability and extent of operation. The 5 year survival rates and prognostic factors were also evaluated. The Kaplan-Meier method, Log-Rank test and Cox hazards proportional mode were used for the statistical analyses. RESULTS: The overall 5 year survival rate was 55.3% in all 133 patients in contrast to 67.4% in 108 patients who underwent gastric resections. Significant prognostic factors were Borrmann type, histologic differentiation, depth of invasion, lymph node metastasis, distant metastasis, location of tumor, size of tumor, curability and extent of operation in univariate analysis. Lymph node metastasis was the only significant independent prognostic factor in multivariate analysis. CONCLUSION: In our study, the 5 year survival rate in young age group was comparable to that of prevalent age group. This is attributed to the relatively higher incidence of early gastric cancer and more frequent curative resections in this young age group.
Classification ; Humans ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Seoul ; Stomach Neoplasms* ; Survival Rate*

The status of metastasis to the regional lymph nodes has been considered to be a major prognostic factor of gastric cancer along with the depth of invasion. So far, the extent of lymph node metastasis has mainly been described by the anatomic location of the involved lymph node, which is an artificial classification. Therefore, a quantitative system such as the number or the ratio of involved lymph nodes emerges as a simple and objective assessment tool. This retrospective study evaluated the prognostic significance of the ratio of involved lymph nodes to resected lymph nodes as an indicator of the status of lymph node metastasis compared to the number of involved lymph nodes in gastric cancer. Five thousand two hundred seventeen consecutive cases of resectable gastric cancer treated at the Department of Surgery, Seoul National University Hospital from 1986 to 1995, were reviewed. Among them, 170 cases with unreliable pathologic reports and 476 cases with less than 15 isolated lymph nodes were excluded to minimize the stage migration phenomenon and to increase the creditability of the ratio, so finally 4571 cases were evaluated. The distributions of the number of cases and the 5-year survival rates were analyzed in a two-dimensional matrix with the ratio of the number of involved to resected lymph nodes on one axis and either the number of involved lymph nodes or the number of resected lymph nodes on the other axis. The other clinicopathologic variables were also evaluated for their prognostic values. The overall 5-year survival rate was 62.4%. The mean number of resected lymph nodes was 4.1(15~168) and the mean number of involved lymph nodes was 5.7. The ratios of involved lymph nodes were evenly distributed in the two matrices and had significant prognostic value in both the involved lymph node matrix and resected lymph node matrix. Age, sex, type of operation, R-category, tumor location, Borrmann type, tumor size, histologic differentiation, Lauren`s classification, depth of invasion, number of involved lymph nodes, ratio of involved lymph nodes to resected lymph nodes, distant metastasis, perineural invasion, lymphatic invasion, and vascular invasion and prognostic significance in univariate analysis and multivariate analysis performed with the above factors revealed that R-category, depth of invasion, and ratio of involved lymph nodes to resected lymph nodes were the independent significant prognostic factors. In the situation where a radical lymph node dissection is performed as the standard operation for gastric cancer, the ratio of involved lymph nodes to resected lymph nodes has a more comprehensive and accurate prognostic value than the number of involved or resected lymph nodes, and it should be considered as an estimate of the nodal status in gastric cancer.
Axis, Cervical Vertebra ; Classification ; Lymph Node Excision ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Seoul ; Stomach Neoplasms* ; Survival Rate