서울아산병원에서 최근 15년간 대장암의 임상 및 병리적 특성의 변화
Trend of Clinicopathologic Characteristics of Colorectal Cancer in Asan Medical Center: a 15-Year Experience
최평화, 정상훈, 김정랑, 유창식, 김희철, 김진천,
소속 상세정보
최평화 ( Choi Pyong-Wha )
울산대학교 의과대학 외과학교실
정상훈 ( Jung Sang-Hun )
울산대학교 의과대학 외과학교실
김정랑 ( Kim Jung-Rang )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0356720060220060387
Abstract
Purpose: A retrospective study was performed to provide an overview of changes over time by age, stage, tumor location, and surgical therapy of colorectal cancer over the past 15 years.
Methods: We analyzed the cases 6,314 colorectal cancer patients who underwent surgery at Asan Medical Center between January 1990 and December 2004. The period was divided into three periods: 1990 to 1994, 1995 to 1999, and 2000 to 2004. We analyzed trends over time for stage, resectability, and demographic factors of colorectal cancer over the past 15 years.
Results: The mean age of the patients in the periods from 1990 to 1994, from 1995 to 1999, and from 2000 to 2004 were 57.1 (21~89), 57.4 (14~91), and 58.9 (15~91) years, respectively, showing an increasing tendency over time (P＜0.001). The male-to-female ratios were 1.2：1, 1.3：1, and 1.6：1, repectively, and this male preponderance has been more marked in recent years (P=0.003). There was no change in tumor location over time. The ratios of early cancer to advanced cancer were 0.06：1, 0.09：1, and 0.11：1, respecfively, showing an increasing tendency over time (P=0.002). The curative resection rate increased over time (P＜0.001). The non-curative resection rate was higher and the non-resected rate was lower in the period 2000 to 2004 than in the period 1990 to 1999 (P＜0.001). The ratios of the lowest anterior resection to the abdominoperineal resection were 0.06：1, 0.49：1, and 1.02：1, respectively. With decreasing tendency of abdominoperineal resection, the lowest anterior resection rate has increased gradually over time (P＜0.001).
Conclusion: Etiologic studies are necessary to understand the male preponderance in colorectal cancer, and multi-center studies should be conducted to understand the changing trend of colorectal cancer in Korea. J Korean Soc Coloproctol 2006;22:387-395
키워드
대장암;변화추이;병기
Colorectal cancer;Trend;Stage
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