3기 직장암 환자에서 림프절 피막 침윤이 예후에 미치는 영향 (Oncologic Impact of Extracapsular Invasion of Nodal Metastasis in Patients with Stage III Rectal Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 25권 / 3호 / 186 ~ 192페이지
· 저자명 : 이기윤, 신진용, 오상훈, 홍관희

초록

Purpose: Extracapsular invasion (ECI) of nodal metastasis is reported to be a prognosticator of colorectal cancer. However,
limited knowledge exists about the prognostic value of ECI in stage III rectal cancer.
Methods: From January 1996 to June 2004, 202 stage III rectal cancer patients who underwent surgery were enrolled in
this study. The patients were divided into two groups according to ECI (patients with ECI, ECIP, n=122; patients without
ECI, ECIN, n=80). The potential prognostic factors were compared in a Cox model.
Results: Of 916 positive nodes examined, ECI was seen in 46.7% of the positive nodes. The univariate comparison between
the two groups revealed the five-year results after a median follow-up of 48.0 mo. The local control rate of ECIP did not show
a significant difference from that of ECIN (77.0% vs. 85.4%, P=0.550). The disease-free survival rate and the overall survival
rate differed for the two groups, with rates of 44.1% and 50.0% for ECIP and 70.4% and 63.2% for ECIN (P<0.001, P=0.049,
respectively). The impact of ECI on the disease-free survival was confirmed in a Cox model. In a subgroup analysis, no
significant differences in the recurrence and the survival rates were seen between the N1 ECIP and the N2 ECIN subgroups.
Conclusion: Although ECI is not a risk factor for survival and local relapse, ECI is a prognosticator of overall recurrence.
Based on these findings, more aggressive adjuvant treatment seems to be needed for decreasing the overall recurrence in
stage III rectal cancer with ECI.

영어초록

Purpose: Extracapsular invasion (ECI) of nodal metastasis is reported to be a prognosticator of colorectal cancer. However,
limited knowledge exists about the prognostic value of ECI in stage III rectal cancer.
Methods: From January 1996 to June 2004, 202 stage III rectal cancer patients who underwent surgery were enrolled in
this study. The patients were divided into two groups according to ECI (patients with ECI, ECIP, n=122; patients without
ECI, ECIN, n=80). The potential prognostic factors were compared in a Cox model.
Results: Of 916 positive nodes examined, ECI was seen in 46.7% of the positive nodes. The univariate comparison between
the two groups revealed the five-year results after a median follow-up of 48.0 mo. The local control rate of ECIP did not show
a significant difference from that of ECIN (77.0% vs. 85.4%, P=0.550). The disease-free survival rate and the overall survival
rate differed for the two groups, with rates of 44.1% and 50.0% for ECIP and 70.4% and 63.2% for ECIN (P<0.001, P=0.049,
respectively). The impact of ECI on the disease-free survival was confirmed in a Cox model. In a subgroup analysis, no
significant differences in the recurrence and the survival rates were seen between the N1 ECIP and the N2 ECIN subgroups.
Conclusion: Although ECI is not a risk factor for survival and local relapse, ECI is a prognosticator of overall recurrence.
Based on these findings, more aggressive adjuvant treatment seems to be needed for decreasing the overall recurrence in
stage III rectal cancer with ECI.

참고자료

· 없음