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[Multivariate Cox analysis on prognostic factors after surgery for rectal carcinoma]
Han Liang1, Xi-shan Hao, Pu Wang
1Department of Gastroenteric Oncology, Tianjin Cancer Hospital, Tianjin Medical University, Tianjin 300060, China. hanliang86@yahoo.com
Objective:
To analyze a large cohort of patients with rectal cancer within a cancer center to determine the prognostic factors by univariate and multivariate analyses.
Methods:
A total of 952 patients with rectal cancer were treated surgically during a period of 10 years. R0, R1 and R2 operations were carried out in 741 patients (77.8%), 75 patients (7.9%) and 136 patients (14.3%), respectively. There were more Miles operation (53.5%) than lower abdominal resection (LAR, 33.7%).
Results:
The operation mortality was 0.3%, 418 patients were dead within 108 months postoperatively due to recurrence or metastases to liver, lung and bone in 53, 39 and 12 patients. The overall mean survival time for all patients was 73.52 +/- 1.70 months and the overall 3-, 5-and 10-year survival rates were 67.6%, 55.4% and 38.2%. The overall 3-, 5- and 10-year survival rates for patients treated by radical operation were 81.4%, 70.3%, 48.8%, respectively. Kaplan-Meier estimate showed that patient gender, age, radicality of resection, histological type, liver and pulmonary metastasis and TNM stage were the predictors of survival. Multivariate analysis showed statistically significant correlation with radicality of operation, histological type, depth of tumor invasion, lymphatic invasion, TNM stage, liver and pulmonary metastasis.
Conclusion:
For survival, statistically significant differences among prognostic factors in relation to radicality of resection, lymphatic invasion, TNM stage, depth of tumor invasion, histological type, liver and pulmonary metastasis are found.