진행성 직장암 환자에서 수술 전 방사선 화학요법 시행 직후 발견된 전신 전이
Distant Metastasis Identified Immediately after Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer
박인자, 김희철, 유창식, 최평화, 정상훈, 홍동현, 김대동, 류민희, 장흥문, 김진천,
소속 상세정보
박인자 ( Park In-Ja )
울산대학교 의과대학 서울아산병원 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 서울아산병원 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 서울아산병원 외과학교실
최평화 ( Choi Pyong-Wha )
울산대학교 의과대학 서울아산병원 외과학교실
정상훈 ( Jung Sang-Hun )
울산대학교 의과대학 서울아산병원 외과학교실
홍동현 ( Hong Dong-hyun )
울산대학교 의과대학 서울아산병원 외과학교실
김대동 ( Kim Dae-Dong )
울산대학교 의과대학 서울아산병원 외과학교실
류민희 ( Ryu Min-Hee )
울산대학교 의과대학 종양내과학교실
장흥문 ( Chang Heung-Moon )
울산대학교 의과대학 종양내과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 서울아산병원 외과학교실
KMID : 0356720070230050327
Abstract
Purpose: This study was designed to analyze the clinical characteristics of patients with immediate distant metastasis after preoperative chemoradiotherapy for locally advanced rectal cancer and to help select patients for preoperative chemoradiotherapy.
Methods: Two hundred eight patients, who underwent preoperative chemoradiotherapy for locally advanced rectal cancer, were included. Patients were excluded from the study if they had tumor types other than an adenocarcinoma, prior chemotherapy, radiotherapy, or hereditary nonpolyposis colorectal cancer. The clinicopathological characteristics of patients with distant metastasis immediately after preoperative chemoradioterapy were compared with those of patients without distant metastasis.
Results: Distant metastases immediately after preoperative chemoradiotherapy were identified in 15 patients (7.2%). The liver was the most common site of metastasis (8/15), followed by peritoneal seeding (4), the lung (2), bone (1), and the aortocaval lymph node (1). Age, sex, chemotherapy regimen used, and primary tumor response for patients with distant metastases were similar to those for patients without distant metastasis. In patients with immediate distant metastasis, pre-chemoradiotherapy CEA was significantly higher (11.1 vs. 7.4 ng/ml; P= 0.003).
Conclusions: Immediate distant metastasis after preoperative chemoradiotherapy is associated with pre- chemoradiotherapy CEA level. A careful work-up is necessary when pre-chemoradiotherapy CEA is higher than the normal range
키워드
수술 전 방사선 화학요법;전이;혈청 암테아성항원치
Preoperative chemoradiotherapy;Metastasis;CEA
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