SEOUL NATIONAL UNIVERSITY HOSPITAL

Gastric cancer is the most common cancer in Korea (18% of new cancer cases in 2005). Seoul National University Hospital has been strong leader in gastric cancer treatment and the cumulative number of gastric cancer surgery at the Department of Surgery has reached 20,000 in 2007. This number of gastric cancer operation is unprecedented for a single medical institute in any country of the world. For a commemoration of this achievement, Seoul National University Hospital held a symposium titled “Current Status of Gastric Cancer Treatment at Korea’s Large Hospitals” on July 14 2007. At the symposium, present status of clinical activities was presented by major high volume gastric cancer centers including Seoul National University Hospital in Korea as well as the National Cancer Center and Cancer Research Hospital in Japan where gastric cancer surgeries was most actively performed.

 

According to Seoul National University Hospital gastric cancer database (over 12,000 gastric cancer patients), the proportion of early gastric cancer was only 23.4 percent in 1986 and has been steadily increased, so the proportion of early gastric cancer surpassed 50 percent in 2006. The 5-year survival rate, which is a index of a cure rate of gastric cancer, also showed an increasing pattern; five-year survival rate of the patients in period 1 (1986-1992) was 63.0 percent, which was increased to 65.2 percent in period 2 (1993-1999) and to 66.3 percent in period 3 (2000-2004).  The improvement of treatment outcome seemed to be closely related to the increase of the proportion of early gastric cancer, which is owing to the popularization of a screening gastroscopy examination that enabled early diagnosis of the gastric cancer in asymptomatic patients. This result emphasize again that early diagnosis by frequent screening gastroscopy examination is as much important as development of new treatment techniques to improve gastric cancer treament.

 

 

 

SNU Hospital Gastric Cancer Operation Team is conducting a gastric cancer operation.

 

 The quality of gastric cancer treatment also indicates the excellence of Seoul National University Hospital as a world leading gastric cancer center. According to the report in British Journal of Surgery in 2005, complication rate and mortality rate has been reported as 17.4% and 0.6%, respectively. These results are comparable to those of leading Japanese gastric cancer centers, and much lower than those of US or Europe which were reported as over 40% of complication rate and 10% of mortality rate.

 

 Many foreign doctors are visiting Seoul National University Hospital to learn about the treatment and research of gastric cancer. If we only count the number of visiting surgeons who stayed more than 1 week at SNUH, over 10 doctors have visited from United States, Japan, Germany, Chile, Singapore, and so on in 2008. It is quite meaningful to have visitors from countries such as United States, Germany, and especially from Japan. A staff surgeon from Singapore visited Department of Surgery for a year to learn gastric cancer surgery and his visit was supported by Singapore government.

 

The pursuit of good service for gastric cancer patients is not limited to the surgical operations. The multidisciplinary team conference is regularly held for the purpose of making the best treatment plan for each patient. The team is consisted of doctors from department of gastroenterology, hemato-oncology, surgery, pathology, radiology and nuclear medicine. The decisions made in the conference are promptly applied to the patients with a help of a coordinator. The coordinator also enhances convenience and satisfaction of the patients by managing schedules of examinations and admission as well as discussing various issues on nursing and diet after the operation. We have educational class for gastric cancer patient and family members; the class contents are surgery-related issues, role of chemotherapy in gastric cancer and nutrition (by surgeon, medical oncologist, nurse and nutritionist)

 

In 2008, a Korean American lady who was living in Los Angeles was referred to Seoul National University Hospital for gastric cancer treatment. She was referred by her son, who is an oncologic surgeon at a famous hospital in Boston. His surgical oncology training was also at a well-known cancer center hospital especially famous for gastric cancer surgery. Her medical expense could have been covered by her US insurance to any hospital in the US. On the other hand, any her medical expense outside of US should be covered by herself. But the family decided to bring her to SNUH. Her operation was successful. This referral means a lot to Seoul National University Hospital.

 

As stated in the vision of Gastric Cancer Treatment Team of Seoul National University Hospital, “Global leader in gastric cancer treatment and research”, adding to the extensive performance of operations and the role as an education center, the gastric cancer team of Seoul National University Hospital is exerting themselves for researches of gastric cancer. Seoul National University Hospital has played critical roles in large scale clinical studies. Examples of domestic multicenter studies are the comparative study between laparoscopic and open surgery for early gastric cancer (KLASS study: prospective randomized controlled trial RCT). The clinical study on the effectiveness of adjuvant chemotherapy after gastric cancer operation (CLASSIC study; international RCT) and the study on survival benefit of reduction surgery for stage IV gastric cancer (REGATTA study; Korea and Japan collaboratory RCT ) is examples of multinational multicenter study. SNUH also provide international standard data center service for REGATTA study without any charge. REGATTA study is the first clinical study for JCOG (Japanese Clinical Oncology Group) collaborating with other group. Furthermore, many basic and translational researches are being conducted.

 

In August 2008, the AJCC TNM classification committee for gastric cancer was held at Roswell Park Cancer Institute, Buffalo, USA for the revision of new (7^th) UICC/AJCC TNM classification which is the universally used staging system of cancers. Dr. Takeshi Sano and Professor Han-Kwang Yang representing International Gastric Cancer Association participated in the meeting with the data of Cancer Research Institute Hospital, Japan brought by Dr. Sano and the data of Seoul National University Hospital brought by professor Yang. The survival data and proposal for the new classification from USA, Japan and KOREA were presented and discussed. The proposal from Korea was used as the main reference for the final revision of the TNM classification. This would be because of the large number of patients in a compact 20 years period and because the data was also valued as showing logically expected stage-wise survival rate according to the stages predicted.  This achievement was not only due to the large number of operations, but also due to all the efforts by gastric cancer team in Seoul National University Hospital to establish and maintain the data for the research of gastric cancer.