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간세포암의 부신 전이 시 외과적 치료의 가능성

Other Titles
 Treatment Modalities for Adrenal Metastasis from Hepatocellular Carcinoma 
 박준성  ;  윤동섭  ;  김경식  ;  최진섭  ;  이우정  ;  지훈상  ;  김병로 
 JOURNAL OF THE KOREAN SURGICAL SOCIETY , Vol.70(5) : 375-379, 2006 
Journal Title
Issue Date
Hepatocelluar carcinoma ; Adrenal metastasis ; Prognosis
Purpose: The adrenal gland is one of most the common sites for an extrahepatic metastasis from a hepatocellular carcinoma (HCC). However, there are no definitive guidelines for the treatment of adrenal metastasis. This study examined the effect of each therapeutic modality in an attempt to clarify the treatment strategy for adrenal metastases from a HCC. Methods: This study reviewed the records of 11,770 consecutive HCC patients in the Yonsei University Medical Center from 1991 to 2005. Among the 11,770 patients, 648 were diagnosed with an extrahepatic metastasis. Of the extrahepatic metastases, 45 (6.9%) had an adrenal metastasis. Among these 45 patients, 15 patients with multiorgan metastases including the adrenal gland were excluded leaving 30 patients for review. The survival duration was evaluated according to the treatment modality, which included an adrenalectomy, non-surgical treatment (TACE, Chemotherapy), and conservative treatment. Results: There were 24 men and 6 women, and the average age was 52.3 years (±9.1 years). The location of the adrenal metastasis was in the Rt, Lt, and both glands in 17 (56.7%), 9 (30.0%), and 4 (13.3%) patients, respectively. The initial HCC had been treated by a hepatectomy in 6 patients, and by non-surgical treatments such as TACE, chemotherapy and radiotherapy in 24 patients. The adrenal metastasis was treated by an adrenalectomy in 5 patients, by non-surgical treatment in 19 patients, and by conservative treatment in 6 patients. The overall median survival duration in the 30 cases was 11.1 months. The median survival time of the adrenalectomy, non-surgical treatment and conservative treatment groups was 21.4 months, 11.1 months, and 2.2 months respectively. The difference in the cumulative survival according to the treatment modality was statistically significant. Conclusion: The prognosis of an adrenal metastasis from HCC is quite poor. However, an adrenalectomy for an adrenal metastasis from a HCC is a safe procedure, and an acceptable way of achieving long-term survival.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Byong Ro(김병로)
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chi, Hoon Sang(지훈상)
Choi, Jin Sub(최진섭)
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