위장관 ( 胃腸管 ) : 대장직장암환자의 예후인자에 대한 다변량분석 : 림프절 전이가 대장직장암환자의 예후에 미치는 영향

• Published in: The Korean journal of gastroenterology Vol. 23; no. 2; pp. 440 - 449
• Main Authors: 김진복, Jin Pok Kim, 박재갑, Jae Gahb Park, 김선회, Sun Whe Kim, 양한광, Han Kwang Yang, 홍성국, Song Cook Hong
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 01-01-1991
• Subjects: Colorecta cancer; Multivariate analysis; prognostic factor; UICC TNM system
• ISSN: 1598-9992

Consecutive 713 patients with resectable colorectal cancer are reviewed to analyze prognostic significance of clinical and pathological factors in colorectal cancer. These patients were treated at the department of surgery, Seoul National University Hospital, Seoul, Korea, from 1973 to 1986. Forty one percent of the patients had colon cancer and 59% had rectal cancer. Factors analyzed are age, sex, duration of symptom, presence of anal bleeding, preoperative serum CEA concentraion, obstruction, tumor size, location of the primary tumor, gross appearance, histologic type, number of lymph node metastasis, and depth of invasion. Survival curves were obtained by Kaplan Meier method. Log-rank test was used to compare survival curves (univariate study) and Cox model was used for multivariate analysis. Because, as a result of multivariate study, tumor location (colon vs. rectum) was one of the significant factors in colorectal cancer patients, the study group was divided into colon cancer group and rectal cancer group. In colon cancer patients, number of lymph node metastasis, depth of invasion, and tumor size are found to be prognostic factors. In rectal cancer patients, number of lymph node metastasis, depth of invasion, and preoperative serum CEA level, are significant. Survival curves according to the common significant prognostic factors, number of lymph node metastasis, and depth of invasion, were analyzed in the colon cancer group and rectal cancer group. In T1 and T2 rectal cancer, 5 year survival rate (5YSR) decreased (75.8%) when LN metastasis was present, but there was no significant difference in 5YSR between patients with 1-3 LN metastasis (43.2%) and those with >3 LN metasstasis (37.0%). In T3 and T4 colon and rectal cancer, 5YSR decreased as the number of LN metastasis increased from 0, 1~3, to> 3 (78.5%, 58.4%, 23.4 % in colon cancer, 54.8%, 37.6%, 16.1%. in rectal cancer). From the results of this study, the authors recommend to use UICC TNM system for colorectal cancer, which system considers the important prognostic factors, the number of postive nodes and depth of invaion.