부산대학교 도서관

This study was conducted to validate the survival benefit of metastasectomy plus chemotherapy over chemotherapy alone for treatment of Krukenberg tumors from gastric cancer and to identify prognostic factors for survival. Clinical data from 216 patients with Krukenberg tumors from gastric cancer were collected. Patients were divided into two arms according to treatment modality: arm A, metastasectomy plus chemotherapy and arm B, chemotherapy alone. Overall survival (OS) was significantly increased in arm A relative to arm B for patients initially diagnosed with stage IV gastric cancer (18.0 months vs. 8.0 months; p < 0.001) and those with recurrent Krukenberg tumors (19.0 months vs. 9.0 months; p=0.002), respectively. Metastasectomy (hazard ratio [HR], 0.458; 95% confidence interval [CI], 0.287 to 0.732; p=0.001), signet-ring cell pathology (HR, 1.583; 95% CI, 1.057 to 2.371; p=0.026), and peritoneal carcinomatosis (HR, 3.081; 95% CI, 1.610 to 5.895; p=0.001) were significant prognostic factors for survival. Metastasectomy plus chemotherapy offers superior OS when compared to palliative chemotherapy alone in gastric cancer with Krukenberg tumor. Prolonged survival applies to all patients, regardless of gastric cancer stage. Metastasectomy, signet-ring cell pathology, and peritoneal carcinomatosis were prognostic factors for survival. Future prospective randomized trials are needed to confirm the optimal treatment strategy for Krukenberg tumors from gastric cancer.
본 연구는 krukenberg 종양을 가진 위암 환자의 치료에서, 전이병변 절제와 항암치료의 병행요법이 항암치료 단독요법보다 생존 이득이 있음을 확인하고 생존에 대한 예후 인자를 확인하기 위해 수행되었다. 위암에서 krukenberg 종양을 가진 216명의 환자에서 임상 데이터를 수집하였다. 환자들은 치료 방법에 따라 두 군으로 분류하였다. A군은 전이병변 절제와 항암치료 병행요법, B군은 항암치료 단독요법만 시행한 환자들이다. 전체 생존기간은 처음 위암4기로 진단받은 환자들에서 A군이 B군보다 통계적으로 유의하게 증가하였고 (18개월 vs 8개월; p