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폐절제술을 시행한 대장직장암의 폐전이 환자에서 예후 예측인자와 생존율 분석

Pulmonary Resection for Metastases from Colorectal Cancer: Prognostic Factors and Survival

대한대장항문학회지 2007년 23권 1호 p.53 ~ 59
이루지, 전호경, 이우용, 윤해란, 김진국, 김관민, 심영목, 이원석, 윤성현,
소속 상세정보
이루지 ( Yi Loo-Ji ) - 성균관대학교 의과대학 삼성서울병원 외과
전호경 ( Chun Ho-Kyung ) - 성균관대학교 의과대학 삼성서울병원 외과
이우용 ( Lee Woo-Yong ) - 성균관대학교 의과대학 삼성서울병원 외과
윤해란 ( Yun Hae-Ran ) - 성균관대학교 의과대학 삼성서울병원 외과
김진국 ( Kim Jhin-Gook ) - 성균관대학교 의과대학 삼성서울병원 흉부외과학교실
김관민 ( Kim Kwhan-mien ) - 성균관대학교 의과대학 삼성서울병원 흉부외과학교실
심영목 ( Shim Young-Mog ) - 성균관대학교 의과대학 삼성서울병원 흉부외과학교실
이원석 ( Lee Won-Suk ) - 성균관대학교 의과대학 삼성서울병원 외과
윤성현 ( Yun Seong-Hyeon ) - 성균관대학교 의과대학 삼성서울병원 외과

Abstract


Purpose: Pulmonary metastases occur in up to 10% of all patients who undergo a curative resection for colorectal cancer. Surgical resection is an important part in the treatment of pulmonary metastasis from colorectal cancer. We analyzed the treatment outcome and the prognostic factors affecting survival in this subset of patients.

Methods: Between October 1994 and December 2004, 59 patients underwent a curative resection for pulmonary metastases from colorectal cancer. Uncontrollable synchronous liver and lung metastasis or synchronous colorectal cancers with isolated lung metastasis were excluded from this study. A retrospective review of the patients’ characteristics and of factors influencing survival was performed. Survival was analyzed by using the Kaplan-Meier method. Comparisons between the groups were performed by using a log-rank analysis and the Cox proportional hazard model.

Results: The 5-year overall survival rate of all patients who received a pulmonary resection was 50.3%. The number of pulmonary metastases was significantly related with survival (P=0.032). A pre-thoracotomy CEA level exceeding 5 ng/ml was related with poor survival (P=0.001). A disease- free interval of greater than 2 years did not correlate with survival after a thoracotomy (P=0.3).

Conclusion: The pre-thoracotomy CEA level and the number of metastases were independent prognostic factors. Resection of a pulmonary metastasis from colorectal cancer may result in improved survival or even cure in selected patients. A pulmonary resection of colorectal cancer is regarded as a safe and effective treatment with low morbidity and mortality rates. J Korean Soc Coloproctol 2007;23: 53-59

키워드

대장직장암;폐전이;수술;암배아성항원;재발
Colorectal cancer;Metastases;Surgery;CEA;Recurrence

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