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학술저널
저자정보
조민정 (울산대학교) 유창식 (울산대학교) 박인자 (울산대학교) 정상훈 (울산대학교) 최평화 (울산대학교) 홍동현 (울산대학교) 김대동 (울산대학교) 김희철 (울산대학교) 김진천 (울산대학교)
저널정보
대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.23 No.6
발행연도
2007.1
수록면
454 - 459 (6page)

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Purpose: Sphincter preservation is one of the main goals in the treatment of rectal cancer. The aim of this study was to evaluate the oncologic safety of a sphincter-saving resection with a distal resection margin of less than 1 cm. Methods: Two hundred forty-eight patients who underwent a sphincter-saving resection between June 1989 and December 2002 and who had a confirmed distal resection margin of less than 1 cm on pathologic examination were included. All patients were evaluated for local and systemic recurrences. Results: The median follow-up period was 45 (6∼144) months. The mean length of distal resection margin was 0.79±0.26 cm. Lower rectalcancer was most common (56.5%). Forty patients (16.1%) experienced recurrence. The local recurrence rate was 3.6%, systemic recurrence rate was 11.7%, and the combined local and systemic recurrence rate was 0.4%. In systemic recurrence, the liver was the most common site, followed by the lung. Among stage II & III groups, patients who underwent adjuvant chemoradiotherapy experienced significantly lower local recurrence compared to patients in the chemotherapy- only or the no-adjuvant group (2.6%, 12.9%, 8.7%, P=0.05). The length of distal resection margin, the total mesorectal excision, the location of tumor, sex, histology, and stage were not associated with local recurrence. Conclusions: A distal resection margin of less than 1 cm in a sphincter-saving resection showed acceptableoncologic outcomes. Adjuvant chemoradiotherapy were beneficial to reduce local recurrence in the stage II and the stage III groups.

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