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박인자 ( Park In Ja ),유창식 ( Yu Chang Sig ),김희철 ( Kim Hui Cheol ),김진천 ( Kim Jin Cheon ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1
Background/Aims: Primary appendiceal adenocarcinoma is a rare neoplasm that constitutes less than 0.5% of all gastrointestinal neoplasm. The aim of this study was to figure out its clinicopathologic characteristics that are not well understood. Methods: We reviewed the medical records of nineteen patients (9 males and 10 females) with histologically proven appendiceal adenocarcinoma. They had been treated at Asan Medical Center between June 1989 and December 2002. Their median follow-up duration was 72.5 months. Results: Their median age was 56.5 (range, 33~80) years. Thirteen patients had mucinous variants and the other five had adenocarcinoma. Seven patients (36.8%) were diagnosed as acute appendicitis. In fact, none of the patients was diagnosed correctly before surgery. The operative procedure, included right hemicolectomy in 9 patients, appendectomy alone in 2 patients, and debulking of their tumors or a biopsy in 8 patients. The 5-year survival rate was 20.5%. The patients with mucinous type had better prognosis than those with the non-mucinous type (p<0.01). In the patients with mucinous type, the survival rate after debulking operation was similar to that after right hemicolectomy. Conclusions: The most important prognostic factor of primary appendiceal adenocarcinoma was histology. The outcome of debulking operation is being watched compared with that of right hemicolectomy in mucinous variant. (Korean J Gastroenterol 2004;43:29-34)
림프절 전이가 없는 T3-4 직장암에서 예후인자의 분석
박인자 ( Park In Ja ),김희철 ( Kim Hui Cheol ),김태원 ( Kim Tae Won ),김종훈 ( Kim Jong Hun ),김정선 ( Kim Jeong Seon ),김정랑 ( Kim Jeong Lang ),유창식 ( Yu Chang Sig ),김진천 ( Kim Jin Cheon ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1
Background/Aims: We aimed to verify the prognostic factors of stage II rectal cancer and the effect of radiation therapy on the survival and local recurrence rate. Methods: This study was undertaken in 202 patients who underwent curative resection of rectal cancer and confirmed to be stage II between July 1989 and December 1996. Univariate and multivariate (Cox`s model) analyses of survival were employed to identify prognostic factors. Statistical significance was assigned by p value of<0.05. Results: Overall recurrence occurred in 32 patients. Four patterns of recurrence were observed: hematogenous recurrence in 17 patients, local recurrence in 11, peritoneal seeding in two and simultaneous hematogenous and local recurrence in two cases. Overall 5-year survival rate was 85.6% and 5year disease free survival rate was 82.8%. There was no significant difference in local recurrence rate and survival according to radiation therapy or location of cancer. In multivariate analysis, the number of harvested lymph node was only a prognostic factor. Conclusions: The number of harvested lymph nodes has prognostic value in stage II rectal cancer. Postoperative radiation therapy should be considered for stage II rectal cancer with poor prognostic factors although radiation did not decrease local recurrence rate in present study. (Korean J Gastroenterol 2004;43:23-28)