췌관선암의 절제술 후 재발에 관한 분석

다국어 초록 (Multilingual Abstract)

Purpose: Most patients who undergo a curative resection of
a pancreatic ductal adenocarcinoma (PDAC) develop recurrence,
usually at the tumor bed or in the liver, which has
been associated with the poor prognosis of a PDAC. In this
study, the clinical characteristics of the recurrences following
curative resection of a PDAC were analyzed to discover the
surgical and adjuvant treatment strategies.
Methods: Between May 1990 and December 2002, 156 patients
diagnosed with a recurrence after curative resection of
a PDAC were analyzed for the pattern of recurrence, time
of recurrence, associations with stage and adjuvant therapy,
and survival using a retrospective review of their medical
records.
Results: Local and systemic recurrences were found in 41.0
and 25.7%, respectively. About half of the recurrences
occurred within 6 months of the operation. A local recurrence
was found more frequently in the body and tail than in the
head, which occurred earlier than a systemic recurrence at
an advanced stage. A local recurrence occurred in 40% of
patients treated with surgery alone, and in 29.4% of those
treated with surgery plus radiotherapy, whereas a systemic
recurrence occurred in 25.5% of patients treated with surgery
alone, and in 17.4% of those treated with surgery plus
chemotherapy. The patients with a local recurrence had asignificantly prolonged median disease free survival time (7.8
months) than those with a systemic recurrence (5.8 months).
The two-year survival rate for the locally recurred patients
was greater than that for those with a systemic recurrence
(23.4% vs. 17.5%).
Conclusion: Our study showed a high rate and early occurrence
of local recurrence, with a poor survival rate within
1 year, even after curative resection of the PDAC. There is
still a great need for advances in meticulous surgical techniques
for the control of local recurrence, especially in body
and tail lesion or an advanced stage, and new adjuvant
therapeutic modalities following curative resection to improve
the survival rate of patients with a PDAC.

다국어 초록 (Multilingual Abstract)

Purpose: Most patients who undergo a curative resection of
a pancreatic ductal adenocarcinoma (PDAC) develop recurrence,
usually at the tumor bed or in the liver, which has
been associated with the poor prognosis of a PDAC. In this
study, the clinical characteristics of the recurrences following
curative resection of a PDAC were analyzed to discover the
surgical and adjuvant treatment strategies.
Methods: Between May 1990 and December 2002, 156 patients
diagnosed with a recurrence after curative resection of
a PDAC were analyzed for the pattern of recurrence, time
of recurrence, associations with stage and adjuvant therapy,
and survival using a retrospective review of their medical
records.
Results: Local and systemic recurrences were found in 41.0
and 25.7%, respectively. About half of the recurrences
occurred within 6 months of the operation. A local recurrence
was found more frequently in the body and tail than in the
head, which occurred earlier than a systemic recurrence at
an advanced stage. A local recurrence occurred in 40% of
patients treated with surgery alone, and in 29.4% of those
treated with surgery plus radiotherapy, whereas a systemic
recurrence occurred in 25.5% of patients treated with surgery
alone, and in 17.4% of those treated with surgery plus
chemotherapy. The patients with a local recurrence had asignificantly prolonged median disease free survival time (7.8
months) than those with a systemic recurrence (5.8 months).
The two-year survival rate for the locally recurred patients
was greater than that for those with a systemic recurrence
(23.4% vs. 17.5%).
Conclusion: Our study showed a high rate and early occurrence
of local recurrence, with a poor survival rate within
1 year, even after curative resection of the PDAC. There is
still a great need for advances in meticulous surgical techniques
for the control of local recurrence, especially in body
and tail lesion or an advanced stage, and new adjuvant
therapeutic modalities following curative resection to improve
the survival rate of patients with a PDAC.