대한대장항문학회

We reviewed and made retrospective follow-up study for the 127 patients who<br>diagnosed by pathologic reports as colorectal cancer and received surgical treatment<br>from Jan. 1982 to Jun. 1992 at Pusan St. Benedict Hospital. The following results were<br>obtained;<br>1) The ratio between male and female was 1：1 and the most prevalent age group<br>was 6th to 7th decade in both male and female.<br>2) The associated colonic disorderes known as precancerous lesions were shown:<br>adenomatous polyp(3 cases), ulcerative colitis(1 case), familial polyposis coli(1 cases).<br>3) The most common site of primary colorectal cancer was the rectosigmoid<br>(rectum(52.0%) and sigmoid colon(12.6%), 64.6%), followed by cecum and ascending<br>colon(17.3%), transverse colon(12.6% ) and descending colon(3.9% ).<br>4) The most common pathologic type was adenocarcinoma(96.1%) moderately<br>-differenciated adenocarcinoma was found in 55.1% of the all patients, well<br>-differenciated adenocarcinoma in 22.0%, poorly differentiated in 8.7%.<br>5) The common gross finding by location; fungating(42.1%) in right side of the colon;<br>stenosing(58.8%, 47.6%) in transverse and left side of the colon; ulcerated(46.2%) and<br>stenosing(30.7% ) in rectum.<br>6) The serum levels of CEA elevated significantly(>3.0 ng/ml) were found in 57.3% of<br>cases.<br>7) The staging of the colorectal cancer was performed according to modified Dukes'<br>classification. The results were as follows: A4.1% Bl and B2 30.3%, C1 and C2 42.6%,<br>and D 23.0%.<br>8) Miles' operation was most frequently Performed(32.8%), followed by<br>right<br>hemicolectomy 19 cases(15.6% ), anterior resection 15 cases(12.3%), colostomy or biopsy<br>only 12 cases(9.8%), transverse colectomy 12 cases(9.9%), low anterior resection<br>9<br>cases(7.4%). Resectability was 91.0% with including curative resectability(71.8%). The<br>ratio of elective-emergency operation was 89.3%.<br>9) The distant metastasis developed in 28 cases(23.0%); peritoneum 19 cases, liver 14<br>cases, multiple 18 cases.<br>10) The postoperative complications of the colorectal carcinoma were found in 33<br>cases of 122 patients(27%) with adenocarcinoma: wound infection(12 cases), anastomotic<br>leakage(3 cases), colostomy complications(3 cases), wound evisceration(2 cases),<br>atelectasis(2 cases), acute renal failure(2 cases) and transient bladder dysfunction(7<br>cases). Operative mortality was 2.5%.<br>11) Follow-ups for 106 patients of adenocarcinoma of colorectum reveals that<br>cumulative 1, 3, 5-year survival rates were 85%, 53%, 34% according to Actuarial life<br>table, respectively.<br>12) Several number of prognostic factors of the colorectal cancer such as stage by<br>modified Dukes' classification, status of the lymph node, histological grade, and the<br>modality of theraphy were strongly correlated to long-term survival rate. But, no<br>correlation to survival rate were observed in the grouping for age of the patients and<br>the location of the tumors.<br>