Clinical Endoscopy

  • 제42권1호
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  • Pages.6-10
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

간문부 담관암에서 광역학 치료의 장기 성적 및 생존율 향상에 미치는 인자

The Long-term Outcome and Predictors for Increased Survival after PDT for Hilar Cholangiocarcinoma

  • 안지호 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 천영국 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 조영덕 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 최현종 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 문종호 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 이태훈 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 박상흠 (순천향대학교 의과대학 내과학교실, 소화기연구소) ;
  • 심찬섭 (건국대학교 의과대학 내과학교실 소화기병센터)
  • Ahn, Ji-Ho (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Cheon, Young-Koog (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Cho, Young-Deok (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Choi, Hyun-Jong (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Moon, Jong-Ho (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Tae-Hoon (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Park, Sang-Heum (Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Shim, Chan-Sup (Digestive Disease Center, Konkuk University College of Medicine)
  • 발행 : 2011.01.30
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 광역학 치료는 수술이 불가능한 간문부 담관암에서 보존적 치료로 효과적이다. 그러나, 아직까지 장기적인 성적 보고는 드물다. 이에 본 연구는 광역학 치료의 장기적인 추적 결과를 알아보고 생존율 향상에 미치는 인자들을 알아보고자 한다. 대상 및 방법: 2001년 1월부터 2010년 4월 1일까지 순천향대학교병원에서 간문부 담관암으로 진단받은 393명 중 다른 보존적 치료의 시행과는 상관 없이 광역학 치료를 시행한 74명을 대상으로 후향적으로 분석하였다. 결과: 진단 후 사망하거나 마지막 추적기간 동안의 생존기간 중앙값은 11.7개월(2.2~78.4개월)이었다. 광역학 치료 후 조직검사에서 음성이 확인된 경우는 1.3%(1/74)였으며, 병변이 표층에 국한되어 있었고 림프절 전이도 없었다. Cox regression 모델을 이용한 다변량 분석에서 진단 후 치료까지의 시간이 짧을수록 통계적으로 유의한 생존기간 증가가 확인되었다[Odds ratio, 3.25; 95% confidence interval (CI), 1.90~4.71, p=0.034]. 결론: 광역학 치료는 담관암의 진행을 예방할 수는 없지만, 담즙 폐쇄를 호전시킨다. 그리고, 진단 후 빠른 광역학 치료가 진행성 간문부 담관암에서 생존율 향상에 기여하였다.

Background/Aims: Photodynamic therapy (PDT) has a promising effect on nonresectable cholangiocarcinoma (CC) but its long term data is not yet available. This study examined the long term outcome and factors associated with increased survival after performing PDT for hilar cholangiocarcinoma. Methods: A list of 393 patients with a diagnosis of hilar CC was retrieved from the database of Soonchunhyang University Hospital (Seoul, Korea) and these patients were seen from January 1, 2001, to April 1, 2010. We retrospectively reviewed the records of 74 patients who underwent PDT in addition to biliary stenting with/without chemoradiation. Results: The median overall survival from the date of diagnosis to death or to the last follow-up was 11.7 months (range: 2.2~78.4). After performing PDT, a complete remission was observed in 1.3% (1/74) of the patients who had a superficial depth of tumor without lymph node involvement. On multivariate analysis using the Cox regression model, increasing the time to treatment after the diagnosis was a statistically significant predictor of shorter survival after PDT [Odds ratio: 3.25, 95% confidence interval (CI): 1.90~4.71, p=0.034]. Conclusions: Although PDT does not prevent progression of CC, it appears to control the cholestasis. The early treatment of PDT after the diagnosis showed a survival benefit for patients with advanced hilar CC.

키워드

참고문헌

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