Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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Treatment Strategy of Intractable Peritoneal Carcinomatosis

난치성 복막암종증의 치료 전략에 대한 고찰

  • Jae Gu Jung (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Yun Jeong Lim (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University-Seoul, Graduate School of Medicine)
  • 정재규 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 임윤정 (동국대학교 의과대학 일산병원 내과학교실)
  • Received : 2012.10.15
  • Accepted : 2012.11.22
  • Published : 2013.03.31
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Abstract

Peritoneal carcinomatosis (PC) is defined as the dissemination of cancer cells in the peritoneal cavity resulting in deposition of malignant cells onto parietal or visceral peritoneal surfaces, and is associated with malignant ascites. In general, PC has been treated similarly to metastatic cancers of the primary tumor, but associated with unfavorable outcomes as compared to other sites of metastatic disease from the same primary tumor origin. It has been known to have the median survival of only 3-6 months with supportive care alone. PC is an intractable problem to physicians because of its poor prognosis and limited treatment options. Recent studies have reported that a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improved survival in PC of colorectal cancer. This paper gives overviews of the characteristics, symptoms, prognosis, and diagnosis of PC and current treatment options on PC of stomach, colorectal, and unknown primary origin.

복막암종증(Peritoneal carcinomatosis)은 복강내에 암세포가 파종되어 벽쪽 복막과 내장쪽 복막 표면에 악성세포가 축적되는 상태로 정의할 수 있으며, 이것은 암성복수와도 관련 있다. 일반적으로 복막암종증은 원발암의 전이성 암과 유사하게 치료하나 같은 원발암의 다른 장기로의 전이암과는 달리 예후가 좋지 않다. 보존적 치료만 했을 경우 복막암종증 환자의 중앙생존기간은 3-6개월이다. 복막암종증은 예후가 좋지 않고 치료 방법이 제한적이어서 일선에서 치료하는 내과 의사에겐 여전히 어려운 과제이기도 하다. 최근에 이와 관련된 치료 방법이 많이 연구되어 육안적 병소제거술 및 복막절제술(cytoreductive surgery with peritonectomy)과 함께 조기 수술 후 복강내 화학요법(early postoperative intraperitoneal chemotherapy, EPIC) 또는 수술 중 복강내 온열화학요법(hyperthermic intraperitoneal chemotherapy, HIPEC)을 시행하여 생존율을 향상시키고 있다. 본 논문에서는 복막암종증의 전반적인 특징, 증상, 예후 및 진단과 수술적 방법, 항암 화학요법 등의 치료법에 대하여 알아보고자 한다.

Keywords

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