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대장암의 근치적 절제술 후 발생한 이시성 간전이에 대한 고주파 온열치료와 절제술의 장기 종양학적 결과 비교
이현구(Hyun Gu Lee),이병철(Byoung Chul Lee),박인자(In Ja Park),김소연(So Yeon Kim),김기훈(Ki-Hun Kim),하태용(Tae Yong Ha),이재훈(Jae Hoon Lee),김찬욱(Chan Wook Kim),이종률(Jong Lyul Lee),윤용식(Yong Sik Yoon),임석병(Seok-Byung Lim),유 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.1
Purpose: We compared oncologic outcomes between surgery and radiofrequency ablation (RFA) in patients with metachronous isolated hepatic metastases from colorectal cancer. Methods: We retrospectively analyzed 123 patients treated with hepatic resection and 82 patients treated with RFA for metachronous hepatic metastases between April 2000 and October 2011. Re-recurrence pattern and 3-year re-recurrence free survival (RFS) rate compared between groups. Factors associated with RFS were evaluated. Results: The patients in the two groups were similar in age, gender, location of primary tumor, disease-free interval to hepatic metastasis, pathological stage of primary disease, number of metastatic lesions. The mean diameter of the biggest hepatic metastatic lesion was significantly larger in the resection group than in the RFA group. The RFS rate after hepatic metastasis treatment was significantly higher in the resection group than in the RFA group (48.6% vs. 33.7%, respectively; P=0.015). Marginal recurrence at the RFA site was observed in 14 of the 82 patients (17.1%). The size and number of metastatic lesions, stage of primary disease, disease-free interval to hepatic metastasis, and modality of treatment were confirmed as re-recurrence-associated factors after hepatic metastasis treatment. Among patients with solitary metastases of ≤3 cm, the RFS rate was not different between the resection and RFA groups (52.4% vs. 53.4%, respectively; P=0.491). Conclusion: Surgical resection for metachronous hepatic metastases achieved higher RFS and lower local recurrence rates. However, the RFS rate in patients with a solitary hepatic metastasis of ≤3 cm was similar between the resection and RFA groups.
자기공명영상 기반의 임상병기 T3N0 직장암 환자에서 수술 전 항암방사선 치료의 무작위적 사용은 적절한가?
김지연(Jee Yeon Kim),박인자(In Ja Park),유창식(Chang Sik Yu),임석병(Seok-Byung Lim),이종률(Jong Lyul Lee),윤용식(Yong Sik Yoon),김찬욱(Chan Wook Kim),김진천(Jin Cheon Kim) 대한종양외과학회 2014 Korean Journal of Clinical Oncology Vol.10 No.1
Purpose: Preoperative chemoradiotherapy (PCRT) has been widely adopted. However, benefit of PCRT for patients with clinically T3N0 (cT3N0) rectal cancer is doubtful. We analyzed oncologic outcome in patients with magnetic resonance image (MRI) staged cT3N0 rectal cancer according to receipt of PCRT. Methods: Between January 2006 and December 2010, one hundred twenty four patients were MRI-based T3N0 rectal cancer. In patients who received PCRT the median dose of given radiotherapy was 5,040 Gy, and either 5-fluorouracil/leucovorin, capecitabine or S-1/oxaliplatin was delivered. The 3-year disease free survival rate (DFS) and sphincter preservation were compared. Results: Sixty four patients received and sixty patients did not receive PCRT. Rate of complete remission was obtained in 17.2% of PCRT group. Sphincter-preserving surgery was performed in 79.7% of PCRT group and 88.3% of non-PCRT group (P=0.194). In patients with low-lying rectal cancer, sphincter-preservation was also not different; PCRT 70.5% and non-PCRT 66.7% (P=0.761). Overall recurrence occurred in 21.9% in PCRT group and 15.0% in non-PCRT group (P=0.327). Three-year DFS was comparable between PCRT (76.5%) and non- PCRT group (79.7%) (P=0.330). Conclusion: Preoperative chemoradiotherapy in MRI-based cT3N0 rectal cancer had no benefit on sphincter preservation and did not improve DFS. Therefore, the routine use of PCRT in cT3N0 rectal cancer should not be warranted.