T1/T2 직장암에 대한 국소절제술의 국소 근치 성적
Local Control of Local Excision for T1/T2 Rectal Cancer
박기재, 최홍조, 노영훈, 신종석, 이형식,
소속 상세정보
박기재 ( Park Ki-Jae )
동아대학교 의과대학 외과학교실
최홍조 ( Choi Hong-Jo )
동아대학교 의과대학 외과학교실
노영훈 ( Roh Young-Hoon )
동아대학교 의과대학 외과학교실
신종석 ( Shin Jong-Sok )
동아대학교 의과대학 외과학교실
이형식 ( Lee Hyung-Sik )
동아대학교 의과대학 방사선종양학교실
KMID : 0356720070230020087
Abstract
Purpose: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection.
Methods: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40∼92) months.
Results: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138).
Conclusion: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences. J Korean Soc Coloproctol 2007;23:87-92
키워드
직장암;국소절제술;국소재발
Rectal cancer;Local excision;Local recurrence
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