원발성 충수암의 임상상과 예후인자 = Clinical Features and Prognostic Factors in Primary Adenocarcinoma of the Appendix

다국어 초록 (Multilingual Abstract)

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)

참고문헌 (Reference)

1 "Third look surgery and beyond for appendiceal malignancy with peritoneal disse-mination" 83 : 5-12, 2003

2 "The natural history of surgically treated primary adenocarcinoma of the appendix" 219 : 51-57, 1994

3 "Primary carcinoma of the appendix" 183 : 53-57, 1976

4 "Primary appendiceal malignancies:rare but important" 111 : 244-250, 1992

5 "Primary appendiceal adenocarcinoma" 22 : 458-459, 1999

6 "Mucinous and nonmucinous appendiceal adenocarcinomas:different clinicopathological features but similar genetic alterations" 15 : 599-605, 2002

7 "Management and prognosis of adenocarcinoma of the appendix" 38 : 848-852, 1995

8 "Epithelial neoplasm of the vermiform appendix exclusive of carcinoid Adenocarcinoma of the appendix" 2493-2510,

9 "Can CEA predict malignancy of cystic tumor of the appendix? Report of a case" 95 : 1381-1383, 2000

10 "Adenocarcinoma of the vermiform appendix" 44 : 218-224, 1990

11 "Adenocarcinoma of the appendix:an unusual disease" 164 : 859-862, 1998

12 "Adenocarcinoma of the appendix" 28 : 457-459, 1985

13 "Adenocarcinoma of the appendix" 24 : 176-180, 1981

14 "Adenocarcinoma of the appendix" 166 : 451-453, 1988