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대장암의 폐전이에 대한 수술 치료의 결과

Surgery for Lung Metastases from Colorectal Cancer

대한대장항문학회지 2002년 18권 1호 p.37 ~ 41
백효채 ( Paik Hyo-Chae ) - 연세대학교 의과대학 흉부외과교실

맹대현 ( Meng Dae-Hyun ) - 건국대학교 의과대학 민중병원 흉부외과
송석원 ( Song Suk-Won ) - 연세대학교 의과대학 흉부외과학교실
김길동 ( Kim Kil-Dong ) - 연세대학교 의과대학 흉부외과학교실
정경영 ( Chung Kyung-Young ) - 연세대학교 의과대학 흉부외과학교실

Abstract


Purpose: The liver and lung are the most common site of metastases after curative resection of colorectal carcinoma, and only 10 months of median survival is achieved once metastases has occurred in the lung. About 10% of patients have a solitary pulmonary metastasis and surgical resection leads to a 5 year survival rate of 21∼43%. We have tried to define ideal candidates for pulmonary resection in a patient with pulmonary metastases from colorectal carcinoma.
Methods: Between March 1990 to Feb. 2001, 25 patients underwent pulmonary resection for metastatic colorectal carcinoma. 15 patients were male, and 10 were female with mean age of 60.0 (range, 36∼73) years. The primary sites were colon in 7 patients and rectum in 18 patients.

Results: The mean disease free interval was 30.04±19.79 (range, 1∼84) months and 19 patients had single metastasis and 6 patients had multiple metastatic lesions. Twenty-one patients had unilateral lesion. Wedge resection was done in 10 patients, lobectomy in 7, pneumonectomy in 2, wedge resection with bilobectomy in 2, segmentectomy and wedge resection in 1, and segmentectomy and lobectomy in 1 patient. Six patients recurred mean 13.7 months after the first operation (range, 1∼33 months) and they underwent wedge resection in 4 and one case each of lobectomy and segmentectomy. Seven patients died during follow up with 3 year survival rate of 70.8% and 5 year survival rate of 43.4%.

Conclusions: The disease free interval, number of metastases, type and location of pulmonary resection, level of carcinoembryonic antigen had no correlation with the survival rate. We conclude that surgical resection of colorectal lung metastases is safe and effective, and every patients should be evaluated as a surgical candidate.

키워드

결직장암;폐장전이;수술적 절제;예후인자;암태아성항원
Colorectal carcinoma;Pulmonary metastases;Surgical resection;Prognostic factor;Carcinoembryonic antigen
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