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대장암 환자에서 근치적 수술 치료 후 연령이 재발 및 생존에 미치는 영향 분석

The Influence of Age on Survival and Recurrence after a Curative Surgical Resection for Colon Cancer Patients

대한대장항문학회지 2009년 25권 6호 p.401 ~ 409
이초록 ( Lee Cho-Rok ) - 연세대학교 의과대학 외과학교실

김영완 ( Kim Young-Wan ) - 연세대학교 의과대학 외과학교실
김남규 ( Kim Nam-Kyu ) - 연세대학교 의과대학 외과학교실
허혁 ( Hur Hyuk ) - 연세대학교 의과대학 외과학교실
민병소 ( Min Byung-Soh ) - 연세대학교 의과대학 외과학교실
이강영 ( Rhee Kang-Young ) - 연세대학교 의과대학 외과학교실
손승국 ( Sohn Seung-Kook ) - 연세대학교 의과대학 외과학교실
조장환 ( Cho Jang-Hwan ) - 연세대학교 의과대학 외과학교실

Abstract


Purpose: This study was performed to evaluate whether age was a factor associated with oncological outcome for colon cancer patients who underwent a curative surgical resection.

Methods: A retrospective study of 2,125 colon cancer patients who underwent surgery between January 1989 to December 2004 was conducted.

Results: Of the 2,125 patients, 1,724 patients underwent a curative resection (R0). The patients with R0 were classified into three groups: group I (n=142) under 40 yr of age, group II (n=1,462) between 40 and 75 yr of age, and group III (n=120) over 75 yr of age. There were no significant differences in gender, tumor diameter, or postoperative complications among the groups. A history of hereditary colon cancer, advanced TNM stage (III, IV), and poorly- differentiated histology were more commonly found in group I. Adjuvant chemotherapy was administered less frequently in group III. In the survival analysis, the cancer-specific survival (CSS) and the disease-free survival (DFS) rates were not different between groups I and II. The CSS and the DFS rates of group III were significantly unfavorable compared with those of groups I and II. On the multivariate analysis, old age (group III), TNM stage, and preoperative CEA level were independent risk factors for CSS and DFS.

Conclusion: In colon cancer patients, tailored approaches according to age, such as early screening in young adults with family history and proper patients selection for adjuvant treatment in old patients, could be needed.

키워드

대장암;연령;생존;재발
Colon cancer;Age;Surviva;Recurrence
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