식도암의 근치적 절제술 후 재발에 대한 임상적 및 병리조직학적 분석

Clinical and Histo-Pathological Analysis for Recurrence after Curative Surgery of Esophageal Cancer

  • 박재길 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭암센타) ;
  • 이재광 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭암센타) ;
  • 곽문섭 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭암센타)
  • 발행 : 2000.07.01

초록

Background; Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. Material and Method; A retrospective review of recurrent patte군 of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. Result; Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. Conclusion; Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.

키워드

참고문헌

  1. New Engl J Med v.326 Combined chemotherapy and radiotherapy compared with radio-therapy alone in patients with cancer of the esophagus Herskovic A;Martz L;Al-Sarraf M(et al.)
  2. Semin Oncol v.21 Chemoradiation as primary management of esophageal cancer Coia LR
  3. J Thorac Cardiovasc Surg v.46 The surgical treatment of carcinoma of the esophagus and cardia Logan A
  4. Ann Surg v.204 Selection of operation for esophageal cancer based on staging Skinner DB;Ferguson MK;Soriano A;Little AG;Victoria M;Staszak VM
  5. Dis Esophagus v.7 Indications for extended three-field lymphadenectomy for esophageal cancer Isono K;Ochiai T;Koide U
  6. Dis Esophagus v.7 Extent of lymphadenectomy in esophagectomy for squamous cell esophageal carcinoma: How much is necessary? Bumm R;Wong J
  7. Oncology v.48 Results of a nationwide study on the three-field lymph node dissection of esophageal cancer sono K;Sato H;Nakayama K
  8. Ann Surg v.192 Treatment of carcinoma of the esophagus: Retrospective study of 2400 patients Giuli R;Gignoux M
  9. Br J Surg v.77 Surgical therapy of esophageal carcinoma Muller JM;Erasmi H;Pichlmaier H(et al.)
  10. Color atlas of surgical anatomy for esophageal cancer(1st ed.) Background of lymph node dissection for squamous cell carcinoma of the esophagus Akiyama H;Tsurumaru M;Ono Y;Udagawa H;Kajiyama Y;Sato T;Iizuka T
  11. 日消外會誌 v.9 식도암에서 림프절전이 특히 상종격전이와 그의 치료대책 木下 嚴;大橋一浪;中川 建
  12. Color atlas of surgical anatomy for esophageal cancer(1st ed.) Milestones along the road to improvement of results in teh treatment of squamous cell carcinoma of the esophagus Inokuchi K;Sato T;Iizuka T
  13. Esoph ague v.12 p53, p21(Wafl/Cipl) and cyclin D1 protein expression and prognosis in esophageal cancer Kuwahara M;Hirai T;Yoshida K(et al.)
  14. 消火器外科 v.20 악성도로 본 위암의 분사 생물학적 특성 靑田和弘;峠 철哉;安井 미;田原榮一
  15. 日消外會誌 v.29 Proliferating cell nuclear antigen 및 Ki-67 발현도로 본 위 내분비세포암의 생물학적 악성도의 평가 山中伸之介;森 壽治;中村 浩(등)
  16. 소화기병세미나 41 v.41 형태병리면에서본 식도암의 악성도 진단 : 掛川暉夫 식도암 : 진단과 치료의 진보 磯野可一
  17. Karkinos v.7 식도암-외과요법의 적응, 치료성적과 대책- 藤田 博正;掛川 揮夫;兵藤 眞(등)
  18. 日外會誌 v.96 식도암에서 국소진전 형식인 신경주위 침윤에 대하여 落合正宏;新井一史;松原俊樹(등)
  19. Dis Esoph agus v.8 Surgical treatment of multiple primary malignancies combined with esophagus and other organs Meguro E;Ishida K;Satoh N(et al.)
  20. Dis Esoph agus v.10 Synchronous and metachronous carcinomas of the esophaogus and head and neck Natsugoe S;Uchino Y;Kijima F(et al.)