완전 절제된 pT1/2N1 비소세포폐암에서 수술 후 재발의 위험 인자 = Risk Factors for Recurrence in Completely Resected pT1/2N1 Non-small Cell Lung Cancer

다국어 초록 (Multilingual Abstract)

Background: Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about 40% and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. Material and Method: From Jan. 1990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. Result: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year survival rate was 41.3%. 5 year freedom-from recurrence rate was 54.1%. Recurrence was observed in 44 (37.6%) patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was 3.3%, which was significantly lower than patients without recurrence (61.3%, p=0.000). In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 (hazard ratio=1.997, p=0.047) was a poor prognostic factor. Conclusion: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cance

국문 초록 (Abstract)

배경: 완전절제는 pT1/2N1 비소세포폐암의 가장 효과적인 치료 방법이지만 수술 후 5년 생존율은 40% 정도이며 많은 환자가 암의 재발로 사망하게 된다. 완전 절제된 pT1/2N1 비소세포폐암에서 재발에 영향을 주는 인자를 규명하고자 하였다. 대상 및 방법: 1990년 1월부터 2003년 7월까지 연세대학교 의과대학 세브란스병원 흉부외과에서 pT1/2N1 비소세포폐암으로 수술받은 환자 117명을 대상으로 환자의 특성, 조직병리학적 소견, 수술방법, 림프절 전이 양상, 술 후 보조요법등과 재발과의 관계를 후향적으로 연구하였다. 결과: 전체 환자의 평균 연령은 59.3 9.1세였으며 T1N1이 14명, T2N1이 103명이었다. 추적관찰기간은 27.5개월이었으며 5년 생존율은 41.3%였다. 수술 후 재발은 44명(37.6%)에서 관찰되었으며 원격전이가 40명이었다. 재발한 환자의 5년 생존율은 3.3%로 재발이 없는 환자(61.3%)에 비해 유의하게 낮았으며(p=0.000), 전체 환자의 5년 무재발률(freedom-from recurrence rate)은 54.1% 였다. 무재발률에 영향을 미치는 요인에 대한 다변량 분석 결과 다림프절군 N1 (multi-station N1)이 단일림프절군 N1 (single station N1)에 비해 재발의 위험도가 1.997배 높았다(p=0.047). 결론: 완전 절제된 pT1/2N1 비소세포폐암 환자들에서 다림프절군 N1이 수술 후 재발의 위험인자였다.

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