대장 및 직장암의 국소재발에 영향을 미치는 인자 분석
Analysis of Clinicopathological Factors Affecting Local Recurrence of Colorectal Cancer after Curative Resection
박찬호, 이호길, 윤민영, 최선근, 허윤석, 이건영, 김세중, 조영업, 안승익, 홍기천, 신석환, 김경래, 우제홍,
소속 상세정보
박찬호 ( Park Chan-Ho )
인하대학교 의과대학 외과학교실
이호길 ( Lee Ho-Kil )
인하대학교 의과대학 외과학교실
윤민영 ( Yun Min-Young )
인하대학교 의과대학 외과학교실
최선근 ( Choi Sun-Keun )
인하대학교 의과대학 외과학교실
허윤석 ( Heo Yoon-Seok )
인하대학교 의과대학 외과학교실
이건영 ( Lee Kun-Young )
인하대학교 의과대학 외과학교실
김세중 ( Kim Sei-Joong )
인하대학교 의과대학 외과학교실
조영업 ( Cho Young-Up )
인하대학교 의과대학 외과학교실
안승익 ( Ahn Seung-Ick )
인하대학교 의과대학 외과학교실
홍기천 ( Hong Kee-Chun )
인하대학교 의과대학 외과학교실
신석환 ( Shin Suk-Hwan )
인하대학교 의과대학 외과학교실
김경래 ( Kim Kyung-Rae )
인하대학교 의과대학 외과학교실
우제홍 ( Woo Ze-Hong )
인하대학교 의과대학 외과학교실
KMID : 0356720050210050320
Abstract
Purpose: Local recurrence after curative resection of colorectal cancer has an important influence on both survival and quality of life. The ability to predict local recurrence after a curative resection of colorectal cancer may be useful for an intensive follow-up program and for a decision on adjuvant radiation or chemotherapy. The aim of this study was to analyze the factors affecting the incidence of local recurrence after a curative resection of colorectal cancer.
Methods: A retrospective review of 390 patients who had a curative resection for a primary colorectal cancer by a single surgeon at the Department of Surgery, Inha University Hospital, between June 1996 and July 2002 was done. The medical records of patients diagnosed with a local recurrence were reviewed. Local recurrence was defined as any recurrence within the field of resection, regardless of the presence or absence of distant metastasis, that was diagnosed by using colonoscopy with biopsy and/or radiologic imaging.
Results: Local recurrences were detected in 40 patients (10.3%). The gender distribution of patients with local recurrence was 24 males and 16 females with a mean age of 59.8 years. The median time to local recurrence was 15 months. The most common site of local recurrence was the anastomosis site, followed by a regional lymph node, the pelvicoperineal area, and the presacral area. Local recurrence was related to the depth of the primary tumor (P=0.027), lymphatics or vascular invasion (P=0.003), perineural invasion (P= 0.000), nodal status (P=0.000), and distant metastasis (P= 0.002). However, there was no statistically significant relation between local recurrence and primary tumor location (P=0.053), primary tumor size (P=0.982), tumor differentiation (0.256), and preoperative CEA level (P=0.481).
Conclusions: The depth of the primary tumor, lymphatics or vascular invasion, and perineural invasion were significant clinicopathologic factors of local recurrence, but tumor location, tumor size, tumor differentiation, and preoperative serum CEA level were not. J Korean Soc Coloproctol 2005;21:320-324
키워드
결장직장종양;국소성종양재발
Colorectal neoplasms;Local neoplasm recurrence
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