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Survival Paradox Between Stage IIB/C (T4N0) and Stage IIIA (T1-2N1) Colon Cancer
DC Field | Value | Language |
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dc.contributor.advisor | 정승용 | - |
dc.contributor.author | 김민정 | - |
dc.date.accessioned | 2017-07-19T10:25:04Z | - |
dc.date.available | 2017-07-19T10:25:04Z | - |
dc.date.issued | 2014-02 | - |
dc.identifier.other | 000000017819 | - |
dc.identifier.uri | https://hdl.handle.net/10371/132678 | - |
dc.description | 학위논문 (석사)-- 서울대학교 대학원 : 의학과, 2014. 2. 정승용. | - |
dc.description.abstract | Introduction: The survival paradox between stage IIB/C (T4N0) and stage IIIA (T1-2N1) colon cancer still remains in the 7th edition of the American Joint Committee on Cancer staging system. This multicenter study aimed to compare the oncologic outcomes of T4N0 and T1-2N1 colon cancers and to investigate the presumptive prognostic factors that might influence the survival paradox.
Methods: Patients who underwent curative surgery for pT4N0 (n = 224) and pT1-2N1 (n = 135) primary colon cancer between January 1999 and December 2010 at 5 tertiary referral cancer centers were included for analysis. The clinicopathologic, treatment-related factors, and oncologic outcomes in terms of the 5-year overall survival (5-OS) and 5-year disease-free survival (5-DFS) were compared. Results: The T4N0 group had significantly worse 5-OS and 5-DFS rates than the T1-2N1 (5-OS: 84.0% vs. 92.3%, p = 0.012 | - |
dc.description.abstract | 5-DFS: 73.6% vs. 88.0%, p = 0.001). T4N0 cancers more frequently showed elevated preoperative carcinoembryonic antigen, lower grade of differentiation, large tumor size, and higher proportions of perineural invasion, microsatellite instability, obstruction, and perforation than T1-2N1cancers. Peritoneal seeding and liver metastasis were the predominant recurrence pattern in the T4N0 and T1-2N1 groups, respectively (p = 0.042). The T4N0 group showed inferior survival to the T1-2N1 group in postoperative adjuvant chemotherapy (5-OS: 87.1% vs. 93.2%, p = 0.045 | - |
dc.description.abstract | 5-DFS: 76.1% vs. 89.0%, p = 0.001).
Conclusions: T4N0 colon cancer had significantly worse oncologic outcomes than T1-2N1 cancer regardless of adjuvant chemotherapy. The survival paradox may result from the biologic aggressiveness of T4N0 colon carcinomas. | - |
dc.description.tableofcontents | Abstract i
Contents iii List of Tables and Figures iv List of Abbreviations v Introduction 1 Material and Methods 4 Results 9 Discussion 28 References 34 Abstract in Korean 39 | - |
dc.format | application/pdf | - |
dc.format.extent | 650632 bytes | - |
dc.format.medium | application/pdf | - |
dc.language.iso | en | - |
dc.publisher | 서울대학교 대학원 | - |
dc.subject | T4N0 | - |
dc.subject | colon cancer | - |
dc.subject | survival paradox | - |
dc.subject | adjuvant chemotherapy | - |
dc.subject.ddc | 610 | - |
dc.title | Survival Paradox Between Stage IIB/C (T4N0) and Stage IIIA (T1-2N1) Colon Cancer | - |
dc.type | Thesis | - |
dc.contributor.AlternativeAuthor | Min Jung Kim | - |
dc.description.degree | Master | - |
dc.citation.pages | v, 40 | - |
dc.contributor.affiliation | 의과대학 의학과 | - |
dc.date.awarded | 2014-02 | - |
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