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재발성 결장 및 직장암의 외과적 치료

Surgical Treatment of Recurrent Colorectal Cancer

대한대장항문학회지 2003년 19권 5호 p.314 ~ 321
구광모 ( Koo Gwang-Mo ) - 지방공사 강남병원 외과

박상수 ( Park Sang-Su ) - 지방공사 강남병원 외과
윤진 ( Yoon Jin ) - 지방공사 강남병원 외과
김일명 ( Kim Il-Myoung ) - 지방공사 강남병원 외과
유병욱 ( Yu Byoung-Uk ) - 지방공사 강남병원 외과
양대현 ( Yang Dae-Hyun ) - 한림대학교 의과대학 외과학교실
조익행 ( Cho Ik-Hang ) - 동부시립병원 외과

Abstract


Purpose: Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer.

Methods: From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival.

Results: Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3.

Conclusion: Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.

키워드

결장직장종양;생존율;국소종양 재발
Colorectal Neoplasm;Survival rate;Neoplasm recurrent;Local
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