대한대장항문학회

Palliative resection in colorectal cancer seems to be questioned due to high mortality<br>and morbidity in spite of relief of cancer symptom and lengthening of survival time. We<br>studied to identify benefits of palliative resection in advanced colorectal cancer. We<br>retrospectively reviewed 96 patients who underwent palliative surgery during June 1989<br>to December 1995 at Asan Medical Center and evaluated quality of life(QOL), rates of<br>morbidity and mortality, chemotherapy response rates, duration of symptom free and<br>survival time. The overall rate of palliative surgery in total colorectal cancer patients<br>was 9.1%(96/1055) and the most common location of primary tumor was rectum. The<br>causes of palliative surgery were hepatic metastases(44), peritoneal disseminations(20),<br>local invasions(17), combined causes(14) and lung metastases(one) in descending order.<br>Postoperative complication was 13.3% (6/45) after resection surgery and<br>25.5%(13/51)after non-resection surgery. Mortality rates was 0 and 9.8 percent,<br>respectively. Improvement of QOL was 75.6% and 72.5%, respectively. However, 30<br>cases(65.2%) showed still moderate or severe degree of poor QOL in non-resection<br>group compared with 11.1% of resection group postoperatively. Response rates of<br>postoperative adjuvant chemotherapy was higher(31.8% vs. 7.4%) and median relief of<br>preoperative cancer symptom was longer(6.2 vs. 3.0 months) in resection group. One<br>year survival rates were 42% in resection surgery and 16.7% in non-resection surgery<br>Palliative resection can improve QOL, response rates of postoperative adjuvant<br>chemotherapy, relief of preoperative cancer symptom and survival rates without increase<br>of morbidity or mortality. So if feasible, palliative resection should be encouraged in<br>selected patients.<br>