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Do Ho Moon, Soung Min Jeon, Na Ri Lee, Kil Hyo Park, Byung Hyo Cha, Chai Young Lee |
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서울대학교 의과대학 내과학교실, 간연구소 |
| 원저 : 말기암 환자에서 악성 위장관 폐색의 임상적 특성 (Original Articles : Clinical analysis of malignant gastrointestinal obstruction in terminal cancer patients) |
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문도호, 전승민, 이나리, 박길효, 차병효, 이채영 |
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| Abstract |
Background : Untreated malignant gastrointestinal obstruction is rapidly fatal and causes various
symptoms and malnutrition, and so decreases the quality of life and shortens the survival. We
reviewed clinical characteristics and analyzed prognostic factors in terminal cancer patients with
malignant gastrointestinal obstruction.
Methods
: We retrospectively reviewed the medical records of 63 patients with malignant
gastrointestinal obstruction who had been confirmed by endoscopy or colonoscopy, upper
gastrointestinal series or barium study and proper radiologic study at Sam Anyang hospital from
May in 2002 to December in 2004. We excluded patients with palliative tumor resection. We analyzed
prognostic factors for overall survival and symptom-free survival.
Results
: There were 30 males (48%) and 33 females (52%), and median age of 63 patients was
64 years. The cause of malignant gastrointestinal obstruction was colorectal (26 patients, 41%),
stomach (19, 30%), pancreas (4, 6%) and others (14, 23%). Twenty one patients (33%) had Eastern
Cooperative Oncology Group (ECOG) performance status of 2 score and 42 patients (67%) 3 or 4
score. Forty two patients (67%) have been performed palliative procedures and 21 patients (33%)
have not. Median survival of patients with palliative procedure was significantly higher than that of
patients who have not been performed palliative procedures (144 days v 45 days, p=0.0001). By
mutivariate analysis, palliative procedures and performance status were independent prognostic
factors. However, age, gender, primary cancer, site of obstruction, and previous chemotherapy were
not independent prognostic factors. Performance status was only independent prognostic factor that
improves symptom free survival in patients with palliative procedures (p=0.014) and median symptom
free survival was 90 days. There was no mortality on palliative procedures.
Conclusions
: We confirmed that palliative procedures and performance status are significant
independent prognostic factors in terminal cancer patients with malignant gastrointestinal
obstruction.(Korean J Med 70:157-164, 2006)
Key Words : Gastrointestinal obstruction, Palliative procedures, Prognosis, Terminal cancer patients |
| Key Words:
Gastrointestinal obstruction, Palliative procedures, Prognosis, Terminal cancer patients |
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