Focused Issue of This Month Sung Hoon Noh, MD, ph.d Department of Surgery, Yonsei University College of Medicine E - mail : sunghoonn@yuhs.ac J Korean Med Assoc 2010; 53(4): 306-310 Abstract The detection rate of early gastric cancer has been increasing owing to advances in diagnostic techniques. Several different types of minimally invasive approaches to improve quality of life have been developed for the treatment of EGC due to excellent prognosis of EGC patients. Although minimally invasive surgery for the treatment of EGC has gained its popularity, most surgeons are still performing conventional method of open surgery. Conventional Open surgery for the treatment of early gastric cancer, however, is needed to reduce the invasiveness under the influence of technique in MIS. Surgical treatment of EGC should be decided on a caseby-case basis and each surgeons method of maximum competency. Keywords: Early gastric cancer; Conventional open surgery; Minimally invasive surgery 306
Table 1. Relative Frequency of Cancer Sites in Korea, 2007 - Korea Central Cancer Registry Type of Cancer Frequency(%) Stomach 16.0 Thyroid 13.1 Colon and Rectum 12.7 Lung 11.0 Liver 9.2 Breast 7.2 Prostate 3.3 Gall bladder etc. 2.6 Pancreas 2.4 Cervix uteri 2.2 Others 20.3 total 100 307
Noh SH Table 2. Five-year survival of major cancer Sites: Both sexes-korea Central Cancer Registry Type of cancer Year Variance in 93~95 96~00 01~05 03~07 5-yr survival* - All 41.2 44.0 53.1 57.1 +15.9 1 Stomach 42.8 46.6 57.3 61.2 +18.4 2 Thyroid 94.2 94.9 98.0 98.8 +4.6 3 Colon and rectum 54.8 58.0 66.1 68.7 +13.9 4 Lung 11.3 12.7 15.6 16.7 +5.4 5 Liver 10.7 13.2 19.4 21.7 +11.0 6 Breast 77.9 83.2 88.0 89.5 +11.6 7 Prostate 55.9 67.2 78.6 82.4 +26.5 8 Gall bladder etc. 17.3 19.7 22.1 23.5 +6.2 9 Pancreas 9.4 7.6 7.4 7.6-1.8 10 Cervix uteri 77.5 80.0 80.9 80.5 +3.0 *variance : difference of 5-yr survival in 2003~2007 compared to that in 1993~1995 Table 3. Treatment options by stage for clinical practice-japanese Gastric Cancer Society N0 N1 T1(M) IA IB -EMR(en block resection) -Modified surgery-b (2.0 cm in diameter) (dirrerentiated type 2.0 cm in diameter, no ulceration -Standard surgery (2.1 cm in diameter) in cases of depressed-type) - Modified surgery-a (other than those above) T1(SM) IA - Modified surgery-a (differentiated-type 1.5 cm in diameter) - Modified surgery-b (other than those above) 308
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