Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Analysis of Surgical Results for the Patients with Pulmonary Metastasis from Colorectal Carcinoma

대장암의 전이성 폐암의 수술 결과에 대한 분석

  • Sim, Hyung-Tae (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Yong-Hee (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Hong-Ju (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chun, Mi-Sun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Bae, Chi-Hoon (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Eung-Sirk (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Seung-Il (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Kwan (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 심형태 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 김용희 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 신홍주 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 천미순 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 배지훈 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 이응석 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 박승일 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 김동관 (울산대학교 의과대학 서울아산병원 흉부외과)
  • Published : 2006.11.05
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Abstract

Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

배경: 폐는 대장암의 가장 흔한 복강 외 전이 장소이며, 폐 전이는 대장암의 근치적 수술 후 약 10%에서 발생된다고 알려져 있다. 폐 전이에 대한 수술 후 5년 생존율은 $9{\sim}47%$로 다양하게 보고되고 있으나 국내에서는 대장암의 폐 전이에 대한 임상연구가 미흡한 상태이다. 이에 저자들은 대장암의 근치적 수술 후 폐 전이가 발생한 환자에서 폐 절제술을 시행하고 그 결과를 후향적으로 분석하였다. 대상 및 방법: 대상 환자는 1996년 7월부터 2003년 12월까지 대장암의 폐 전이로 폐절제술을 시행 받은 61명을 대상으로 하였다. 연구는 대장암 병기, 폐 전이의 위치, 폐절제술의 방법, 전이된 폐 결절의 수와 크기, 재발, 생존 등을 조사하여 그 예후 인자를 알아보고자 하였다. 결과: 환자들의 평균 3년, 5년 생존율은 각각 61%, 41%였다. 단변량 및 다변량 분석에서 통계학적으로 유의한 예후 인자는 없었다. 환자들의 평균 무병 기간은 17개월이었다. 수술 후 재발은 폐가 가장 흔한 위치였고, 이 중 3명의 환자에서 재수술을 시행하여 2명은 현재까지 생존해 있다. 결론: 대장암의 근치적 수술 후 폐 전이 발생 시 수술적응이 되는 경우 폐절제술을 시행하는 것이 좋은 결과를 기대할 수 있는 적절한 치료방법이라고 생각한다.

Keywords

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