국소 진행성 결장암에서의 인접장기 절제의 효과 (Concomitant Adjacent Organ Resection in Locally Advanced Colon Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 2호 / 94 ~ 99페이지
· 저자명 : 조성욱, 이령아, 정순섭, 김광호

초록

Purpose: In locally advanced adherent colon cancer surgery, a mutivisceral resection is known to reduce local recurrence
and improve survival. Practically, the benefit of using this procedure may outweigh the risk of associated morbidity, but the
procedure may not be performed uniformly. We reviewed the results of multivisceral resections for locally advanced colon
cancer.
Methods: From 2003 January to 2008 January, 476 colon cancer patients underwent surgery for locally advanced colon
cancer in our hospital. Out of the 476 patients, 36 patients with pT3-pT4 who underwent any kind of adjacent organ resection
other than a resection of the colon were reviewed retrospectively.
Results: Out of the 36 patients, 22 were male and 14 were female, and the mean age was 63.44±13.26 yr. The sigmoid
colon was the most common location for the primary lesion, followed by the ascending colon, the transverse colon, and the
cecum. Invaded organs were the abdominal or pelvic wall in 5 patients, the visceral organs in 26 patients, the retroperitoneum
in 2 patients. All patients received an en-bloc resection of the invaded organs. Ten patients were stage II, 14 patients were
stage III, and 12 patients were stage IV. Fifteen patients were disease free at the end of this study, local recurrence had
occurred in 1 patient, 6 patients had an intraabdominal recurrence, and 2 patients had developed a distant metastasis. The
overall complication rate was 28%. The 5-yr survival rate of each stage according to the surgical approach did not show any
meaningful difference.
Conclusion: A multivisceral en-bloc resection has been recommended for locally advanced adherent colon cancer patients.
To improve the outcome, we suggest progressive surgical treatment in such patients.

영어초록

Purpose: In locally advanced adherent colon cancer surgery, a mutivisceral resection is known to reduce local recurrence
and improve survival. Practically, the benefit of using this procedure may outweigh the risk of associated morbidity, but the
procedure may not be performed uniformly. We reviewed the results of multivisceral resections for locally advanced colon
cancer.
Methods: From 2003 January to 2008 January, 476 colon cancer patients underwent surgery for locally advanced colon
cancer in our hospital. Out of the 476 patients, 36 patients with pT3-pT4 who underwent any kind of adjacent organ resection
other than a resection of the colon were reviewed retrospectively.
Results: Out of the 36 patients, 22 were male and 14 were female, and the mean age was 63.44±13.26 yr. The sigmoid
colon was the most common location for the primary lesion, followed by the ascending colon, the transverse colon, and the
cecum. Invaded organs were the abdominal or pelvic wall in 5 patients, the visceral organs in 26 patients, the retroperitoneum
in 2 patients. All patients received an en-bloc resection of the invaded organs. Ten patients were stage II, 14 patients were
stage III, and 12 patients were stage IV. Fifteen patients were disease free at the end of this study, local recurrence had
occurred in 1 patient, 6 patients had an intraabdominal recurrence, and 2 patients had developed a distant metastasis. The
overall complication rate was 28%. The 5-yr survival rate of each stage according to the surgical approach did not show any
meaningful difference.
Conclusion: A multivisceral en-bloc resection has been recommended for locally advanced adherent colon cancer patients.
To improve the outcome, we suggest progressive surgical treatment in such patients.

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