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간전이가 동반된 결장직장암의 임상병리학적 소견

Clinicopathologic Features of Colorectal Cancer with Liver Metastases

대한대장항문학회지 2004년 20권 4호 p.211 ~ 217
최선근 ( Choi Sun-Keun ) - 인하대학교 의과대학 외과학교실

전용선 ( Jeon Yong-Sun ) - 인하대학교 의과대학 방사선과학교실
배선영 ( Bae Sun-Young ) - 송도병원
곽민근 ( Kwak Min-Keun ) - 서울외과
허윤석 ( Heo Yoon-Seok ) - 인하대학교 의과대학 외과학교실
이건영 ( Lee Kun-Young ) - 인하대학교 의과대학 외과학교실
김세중 ( Kim Sei-Joong ) - 인하대학교 의과대학 외과학교실
조영업 ( Cho Young-Up ) - 인하대학교 의과대학 외과학교실
안승익 ( Ahn Seung-Ick ) - 인하대학교 의과대학 외과학교실
홍기천 ( Hong Kee-Chun ) - 인하대학교 의과대학 외과학교실
신석환 ( Shin Suk-Hwan ) - 인하대학교 의과대학 외과학교실
김경래 ( Kim Kyung-Rae ) - 인하대학교 의과대학 외과학교실
우제홍 ( Woo Ze-Hong ) - 인하대학교 의과대학 외과학교실

Abstract


Purpose: The aim of this study was to clarify the clinicopathologic features in colorectal cancer with liver metastases and to evaluate their clinical significance.

Methods: From August 1996 to April 2002, 545 patients, who underwent radical surgery for primary colorectal cancers, were analyzed retrospectively.

Results: Colorectal cancers with and without synchronous liver metastases at the time of the surgery were 36 and 509 cases, respectively. Of the 509 cases without metastases, 34 cases had metachronous liver metastases by April 2002, but the others did not. Serosal, vascular, perineural, and lymph node invasions, as well as increased preoperative CEA levels, were more frequently observed in those with synchronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, lymph node invasion was statistically significant as an independent variable in those with synchronous metastases (P=0.009). Serosal, vascular, and lymph node invasions, increased preoperative CEA levels, DNA ploidy, and positive lateral resection margins were more frequently observed in those with metachronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, vascular invasion was statistically significant in those with metachronous metastases (P=0.015).

Conclusions: Lymph node and vascular invasions appear to be significant determinants for synchronous and metachronous liver metastases in colorectal cancers. Therefore, close observation and careful postoperative follow-up is needed for such patients. J Korean Soc Coloproctol 2004;20:211-217

키워드

결장직장암;간전이;혈관침습;림프절전이
Colorectal cancer;Liver metastases;Vascular invasion;Lymph node invasion
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