대장직장암 근치수술 후 흉부단순촬영은 폐전이 진단에 유용한가?
Is Routine Chest X-ray Useful in Detection of Pulmonary Metastases after Curative Resection for Colorectal Carcinoma?
윤성현, 박승배, 강신재, 박치민, 정극원, 장원영, 이우용, 전호경,
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윤성현 ( Yun Seong-Hyeon )
성균관대학교 의과대학 삼성서울병원 외과학교실
박승배 ( Park Sung-Bae )
성균관대학교 의과대학 삼성서울병원 외과
강신재 ( Kang Shin-Jea )
성균관대학교 의과대학 삼성서울병원 외과학교실
박치민 ( Park Chi-Min )
성균관대학교 의과대학 삼성서울병원 외과학교실
정극원 ( Jung Keuk-Won )
성균관대학교 의과대학 삼성서울병원 외과
장원영 ( Chang Weon-Young )
제주대학교 의학전문대학원 외과학교실
이우용 ( Lee Woo-Yong )
성균관대학교 의과대학 삼성서울병원 외과학교실
전호경 ( Chun Ho-Kyung )
성균관대학교 의과대학 삼성서울병원 외과학교실
KMID : 0356720040200030169
Abstract
Purpose: This study was performed to evaluate the effectiveness of conventional chest radiography and abdominal CT for early detection of pulmonary metastases after curative surgery for colorectal cancer.
Methods: We retrospectively reviewed 138 cases of pulmonary metastases from a group of colorectal-cancer patients, who were recruited from 1994 to 2002 at Samsung Medical Center, Sungkyunkwan University School of Medicine, and who had been surgically treated with a curative resection.
Results: The detection rates for pulmonary metastases were 34.1% by conventional chest radiography, 50.0% by abdominal CT, and 15.9% by other means. For stage I and II tumors, conventional chest radiography was superior to abdominal CT (45.7% vs. 34.3%, P＜0.05) for detecting pulmonary metastases. On the contrary, for stage III tumors, abdominal CT was superior to conventional chest radiography (55.3% vs. 30.1%, P＜0.05). Compared with stage I and II, pulmonary metastases in stage III had a tendency to be more numerous, bilateral, and extra-pulmonary. They also had a low detection rate by conventional chest radiography and a higher detection rate by abdominal CT, and they were associated with poor survival.
Conclusions: Conventional chest radiography is no more useful in detecting early pulmonary metastases after curative colorectal surgery than abdominal CT, especially for stage III tumors. We propose the use of routine chest CT or extended abdominal CT for screening of occult lung metastases in stage III colorectal cancer patients. J Korean Soc Coloproctol 2004;20:169-175
키워드
대장 직장암;폐전이;흉부방사선촬영술;복부 단층촬영술;폐전이 선별검사
Colorectal cancer;Pulmonary metastases;Chest X-ray;Abdominal CT;Screening of pulmonary metastases
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