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J Korean Soc Ther Radiol > Volume 9(2); 1991 > Article
Journal of the Korean Society for Therapeutic Radiology 1991;9(2): 249-252.
The Analysis of Failure Pattern in Locally Advanced Stomach Cancer Treated with surgery and Post-Op Chemotherapy: To Explore The Role of Post-Op Irradiation
Eun Kyung Choi, Hyesook Chang, Cheolwon Sun, Kyoo Hyung Lee, Jung Shin Lee, Sang Hee Kim, Hae Ryun Kim, Myung Hwan Kim, Young Il Min, Jin Cheon Kim, Sung Gyu Lee, Kun Choon Park
1Department of Therapeutic Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
2Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
3Department of General Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
A Retrospective study to analyze the failure pattern in locally advanced stomach cancer, trated with radical surgery and post-op chemotherapy was perfomed. Among 107 patients who underwent radical gastrectomy in Asan Mdical Center between June 1989 and August 1990. there were 20 stage II(T2NO,T2N1) and 87 stage III(T3N1,T3N2) and 91 patients were eligible for study. 57 patients treated with 6 cycles of postop adjuvant chemotherapy. A mong 57 patients treated with postop adjuvant chemotherapy, local failure occurred in 21% and distant failure in 12%. Among 34 patients who were not treated with postop chemotherapy, local failure occurred in 24% and distant failure in 26%. Among 29 failures including 13 locoregional, 9 distant metastasis and 7 locoregional and distant metastasis, 11 cases recurred in the anastomotic aite, 3 in the gastric bed, 7 in the regional lymph nodes and peritoneal seeding occurred in 6 cases. The true incidences of gastric bed, nodal and peritoneal failures may be higher in the longer follow-up or reoperative or autopsy series. Our data suggest that postop chemocherapy is beneficial by reducing distant failure rate. Potop adjuvant locoregional radiotherapy in addition to the systemic adjuvant therapy may reduce the local failure rate and potentially benefit in at least 20% of patients who developed the local failure only.
Key Words: Stomach cancer, Chemotherapy, Failure pattern
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