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폐쇄성 좌측 대장암 환자의 특징 및 예후: 환자-대조군 연구

The Characteristics and Prognosis of Patients with Obstructing Carcinoma of the Left Colon and Rectum: A Case-Control Study

대한대장항문학회지 2004년 20권 5호 p.303 ~ 310
이인택 ( Lee In-Taek ) - 경북대학교 의과대학 외과학교실

최규석 ( Choi Gyu-Seog ) - 경북대학교 의과대학 외과학교실
이종호 ( Lee Jong-Ho ) - 경북대학교 의과대학 외과학교실

Abstract


Purpose: Many reports have described significantly lower survival rates for patients with obstructing colorectal cancer than for patients with non-obstructing colorectal cancer. The aim of this retrospective study was to assess the long-term prognosis of patients with obstructing carcinomas of the left colon and rectum and to identify the clinical and pathologic characteristics that affect the prognosis.

Methods: From June 1996 to October 2003, 46 patients with obstructing left colon and rectal cancer underwent curative surgery (case group), and from the patients with
non- obstructing left colon and rectal cancer who had curative surgery, 48 patients with clinicopathologic characteristics similar to those of the case group were selected
and matched as a control group. A comparative analysis of demographic, clinical, and pathologic characteristics, the recurrence rate, and the long-term survival rate between
these two groups was done.

Results: Emergency operations were done more frequently for obstructing
cancer than for non-obstructing cancer (P=0.0001), and more patients with obstructing cancer presented to non-specialists (P=0.0001). The overall recurrence rate
was significantly higher in obstructing cancer patients than in non-obstructing cancer patients. Further, the 5-year overall and the disease-free survival rates were significantly
lower in obstructing cancer patients when examining either overall patient outcome or stage-III patients outcome.

Conclusions: The long-term prognosis of patients with obstructing carcinomas of the left colon and rectum is poor. We suggest that the poor general condition
of patients with obstructing cancer, the increased number of emergency operations involving those patients, and more patients with obstructing cancer presenting to non-specialists may contribute to poor long-term prognosis for obstructing cancer patients. J Korean Soc Coloproctol 2004;20:303-310

키워드

폐쇄성 좌측 대장암;환자-대조군 연구;예후
Obstructing left colorectal cancer;Case-control study;Prognosis
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