대한대장항문학회

Although both the large bowel mucosa and large bowel cancer appear morphologically<br>indentical in males and females, there is some evidence of gender difference in large bowel cancer. Purpose: The aim of this study was to review the differences in incidence, site distribution, and mortality of large bowel cancer between both sexes. Methods: In our<br>hospital, we have experienced 671 patients with colorectal cancer who had operation from<br>Jan. 1980 to Feb. 1998. We analyzed retrospectively those patients and considered several<br>factors between both sexes, which were age, location of tumor, size of tumor, histologic types, depth of invasion, lymph node status, tumor stage, distant metastasis, serum CEA level, DNA ploidy pattern, recurrence rate, prognosis, and prognosis in reproductive age. Results: 1) The sex ratio was 1.1：1 (male=368 patients, female=323 patients). 2) The number of patients who showed the tumor size below 5 ㎝ in diameter was significantly higher in female than male (62.5% vs 48.9%) (p＜0.001). 3) In the location of tumor, sigmoid colon cancer was more in male but middle & lower rectal cancer was more in female (p=0.03). 4) In the depth of tumor invasion, female patients showed more superficial invasion (T1, T2) than male (p=0.01). 5) There was no significant difference in lymph node metastasis between both sexes. 6) In the tumor stage, stage I cancer was more frequent in female and stage IV cancer was more frequent in male (p=0.04). 7) There was no significant differences in distant metastasis, DNA ploidy pattern, preoperative serum CEA level, recurrence rate. 8) The overall 5 year survival rate of female patients was 53.2% and that of male patients was 59.9%. But there was no significant difference statistically (p=0.97). 9) The 5 year survival rate of female in reproductive age (below 40 years) was slightly low than male in same age (52.0% vs 60.0%).<br>But it did not show significant difference (p=0.67). Conclusions: In colorectal cancer, female patients had smaller sized tumors, lower rectal cancers, more superficial invaded tumors, earlier cancers than male patients. But overall survival rate and that of reproductive aged patients didn큧 showed significant difference between both sexes.