자궁 경부 선암의 치료 실패를 초래하는 예후인자

Abstract

[한글]

오늘날 자궁경부선암은 빈도가 점점 증가추세에 있고, 중요성이 더해지고 있는 실정이다. 자궁경부선암은 자궁경부편평암에 비해서 치료방법 및 결과들이 다른 것으로 알려졌고, 오히려 치료효과가 낮은 것으로 알려졌다. 1981년 1월부터 1989년 12월까지 연세의료

원 산부인과에 내원하여 자궁경부선압으로 진단받고 치료받은 39에의 환자를 대상으로 한 본 연구결과 자궁경부선암은 50대가 가장 많았고, 대부분 경산부였으며 가장 흔한 증상은 비정상적인 질출혈이었다. 치료방법으로는 수술요법, 방사선치료, 방사선 및 수술요법

, 항암화학 방사선요법 등을 시행했으며 임상적 병기, 종괴의 크기, 자궁의 크기 등이 5년 무병 생존율에 영향을 미쳤으며 병기가 늦고 종괴의 크기가 클수록 또한 자궁의 크기가 클수록 생존율이 낮았다.

Prognostic Factors Causing Treatment Failure in Adenocarcinoma of the Uterine

Cervix

Choi Nam Jong M.D.

Department of Obstetrics and Gynecology, The Graduate School,

Yonsei University

(Directed by Professor Tchan Kyu Park M.D.)

1. The age distribution of patients with adenocarcinoma showed that those in

their 50's decade were the most common(46.1%), followed by the 40's decade group,

greater than 60's and 30's as decreasing in order.

2. For the parity, 39 patients were multiparas, and 87.2% of the patients have

more than Gravida.

3. The most common presenting symptoms were abnormal vaginal bleeding 43.6%,

cxcessive vaginal discharge, and low back pain.

4. The frequency of associated medical problems were obesity in 43.6%

hypertension in 28.2%, diabetes mellitus in 5.1%.

5. The distribution of the stages of adenocarcinoma showed 9 cases with stage Ⅰ,

22 cases with stage Ⅱ, 7 cases with stage Ⅲ, and 1 case with stage Ⅳ.

5. In 9 stage Ⅰpatients, 4 patients under went surgery, the other 5 patients

under went radiotherapy. In 22 stage Ⅱ patients, 2 patients under went surgery, 3

patients under went surgery combined with radiotherapy, 3 patients had taken

chemoradiotherapy the other 14 patients had taken radiotherapy.

In 7 stage Ⅲ patients, 6 patients had taken radiotherapy, the other one had

taken chemoradiotherapy. One stave Ⅳ patients had taken radiotherapy.

7. Tumor sizes less than 4cm occured in 22 cases, 4-5.9cm sized tumors occured in

8 cases, and 6 cases had tumors size larger than 6cm. The disease free five year

survival rate for tumors size less than 4cm was 87.8%, for tumors size between

4-5.9cm it was 41.7%, and 0% for tumors size larger than 6cm.

8. The number of patients with normal sized uteri was 19 cases, 13 cages had

uteri less then 6 weeks size, and 7 cases had uteri larger than 6 weeks size.

Follow-up showed that the disease free 5 year survival rate was 90.6%, 76.3%, and

33.3% respectively.

[영문]

1. The age distribution of patients with adenocarcinoma showed that those in their 50's decade were the most common(46.1%), followed by the 40's decade group, greater than 60's and 30's as decreasing in order.

2. For the parity, 39 patients were multiparas, and 87.2% of the patients have more than Gravida.

3. The most common presenting symptoms were abnormal vaginal bleeding 43.6%, cxcessive vaginal discharge, and low back pain.

4. The frequency of associated medical problems were obesity in 43.6% hypertension in 28.2%, diabetes mellitus in 5.1%.

5. The distribution of the stages of adenocarcinoma showed 9 cases with stage Ⅰ, 22 cases with stage Ⅱ, 7 cases with stage Ⅲ, and 1 case with stage Ⅳ.

5. In 9 stage Ⅰpatients, 4 patients under went surgery, the other 5 patients under went radiotherapy. In 22 stage Ⅱ patients, 2 patients under went surgery, 3 patients under went surgery combined with radiotherapy, 3 patients had taken chemoradiotherapy the other 14 patients had taken radiotherapy.

In 7 stage Ⅲ patients, 6 patients had taken radiotherapy, the other one had taken chemoradiotherapy. One stave Ⅳ patients had taken radiotherapy.

7. Tumor sizes less than 4cm occured in 22 cases, 4-5.9cm sized tumors occured in 8 cases, and 6 cases had tumors size larger than 6cm. The disease free five year survival rate for tumors size less than 4cm was 87.8%, for tumors size between

4-5.9cm it was 41.7%, and 0% for tumors size larger than 6cm.

8. The number of patients with normal sized uteri was 19 cases, 13 cages had uteri less then 6 weeks size, and 7 cases had uteri larger than 6 weeks size.

Follow-up showed that the disease free 5 year survival rate was 90.6%, 76.3%, and 33.3% respectively.