Surgical Treatment of Recurrent Colorectal Cancer

PURPOSE: Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer. METHODS: From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival. RESULTS: Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3. CONCLUSIONS: Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.

Surgical Guideline of Polypoid Lesions of Gallbladder / 한국간담췌외과학회지

BACKGRAOUND/AIMS: The biologic nature of polypoid lesions of gallbladder is difficult to define before surgical intervention and operative indication is still controversial. The aim of this study is to provide surgical guideline for polypoid lesions of gallbladder. METHODS: Clinical data were retrospectively correlated with the histopathologic characteristics of polypoid lesions of gallbladder in 48 patients who had cholecystectomy from January 1992 to August 2002 in the Department of Surgery, Kang-nam General Hospital Public Corporation. RESULTS: There were 40 benign polypoid lesions including 30 cholesterol polyps, 5 adenomas, 4 inflammatory polyps and 1 adenomyomatous hyperplasia and 8 malignant polypoid lesions. Data analysis showed that neoplastic polypoid lesions of gallbladder correlated significantly with size and malignant polypoid lesions of gallbladder correlated significantly with size and age. CONCLUSION: The risk factor for neoplasm was the size of the polypoid lesions of gallblaldder (> or =10 mm) and the risk factors for malignancy were the size of the polypoid lesions of gallblaldder (> or =10 mm) and age (> or =50). Surgical intervention should be considered when a polypoid lesion of the gallbladder is larger than 10 mm and patient is older than 50 years.