대장암 근치적 절제술후 재발양상에 관한 임상적 연구
Recurrent Colorectal Carcinoma
이길연, 박주철, 홍성화, 고석환, 윤충, 고영관, 이기형,
소속 상세정보
이길연 ( Lee Kil-Yeon )
경희대학교 의과대학 외과학교실
박주철 ( Park Joo-Chul )
경희대학교 의과대학 흉부외과학교실
홍성화 ( Hong Sung-Wha )
경희대학교 의과대학 외과학교실
고석환 ( Koh Suck-Hwan )
경희대학교 의과대학 외과학교실
윤충 ( Yoon Choong )
경희대학교 의과대학 외과학교실
고영관 ( Ko Young-Kwan )
경희대학교 의과대학 외과학교실
이기형 ( Lee Kee-Hyung )
경희대학교 의과대학 외과학교실
KMID : 0356719960120020261
Abstract
Between January 1987 to December 1992, 391 cases with colorectal cancer underwent curative surgery at our institution. Of 391 cases, 348(89 per cent) were able to established the follow up study. Of these cases, 83(23.9 per cent) were detected
recurrence, 47/200(23.5 percent) in colon and 36/148(24.3 percent) in rectum, during the follow-up period. The recurrent sites were 21 in liver, 15 in lung, 16 in locoregional area, 22 in peritoneal area, and 9 in multiorgan recurrences. The mean disease free intervals between operation and recurrence was 12 months in liver, 20 months in lung, 12 months in locoregional area, 11 months in peritoneal area, and 10 months in multiorgan recurrences. There were no significant differences in disease free intervals between Astler-Coiler B(13.00±7.80 months) and Astler-Coller C(13.02±8.23 months).
However, Astler-Coiler B cases were apt to recur in locoregional area compared with being apt to recur systemincally such as liver and lung in Astler-Coiler C. The comparison of disease free interval depend upon location between colon(10.93±7.23 months) and rectum(14.95±8.37 months) was significantly longer interval in rectal cancer(p<0.05).
Reoperations for cure intention were performed on 13 cases(5 in liver, 4 in lung, 4 in locoregional area). While the mean disease free intervals for resectable cases of liver and lung recurrences (14.0±5.24 months and 25.25±5.56 months, respectively) were longer interval compared with palliative resection or non-resectable cases(11.75±6.72 months and 17.64±8.36 months, respectively). However, the mean disease: free intervals for resectable cases in the locoregional recurrence were shorter interval compared with palliative resection or non-resectable cases(8.0±5.48 months and 13.75±5.93 months ,respectively). Nevertheless, the result of the resectable cases in locoregional recurrence was discouraged on our study. In conclusion, the reoperation for the cases of liver and lung recurrence with long disease free interval was warranted to promote the prolongation of survival. On the other hand, the reoperation for locoregional recurrence was meaningless procedure except only a few elected cases on our study.
키워드
Colorectal Neoplasms;Recurrence
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