특징적 임상 양상 및 예후를 가지는 결장 및 직장의 점액성 선암
Characteristic Clinical Behaviors of and Prognosis for Mucinous Adenocarcinomas in the Colon and Rectum
유윤식, 김희철, 박상준, 유장학, 김정선, 이강홍, 유창식, 김진천,
소속 상세정보
유윤식 ( Yoo Yuen-Sik )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
박상준 ( Park Sang-Jun )
울산대학교 의과대학 외과학교실
유장학 ( Yoo Jang-Hak )
울산대학교 의과대학 외과학교실
김정선 ( Kim Jung-Sun )
울산대학교 의과대학 병리학교실
이강홍 ( Lee Kang-Hong )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0356720030190060379
Abstract
Purpose: The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas.
Methods: Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0～113) months for mucinous adenocarcinomas and 32 (0～130) months for non-mucinous adenocarcinoma.
Results: Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P＜0.001), frequent family history (P＜0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P＜0.001), and common peritoneal seeding at diagnosis (P＜0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant.
Conclusions: Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed. J Korean Soc Coloproctol 2003;19:379-385
키워드
결장직장종양; 점액성 선암;예후;생존율
Colorectal neoplasms;Adenocarcinoma Mucinous;Prognosis;Survival rate
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