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Prognostic value of additional pathological variables for long-term survival after curative resection of rectal
Bojan Krebs1, Miran Kozelj, Rajko Kavalar
1Department for abdominal surgery, Teaching Hospital Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia. b.krebs@sb-mb.si
Aim:
To evaluate the prognostic value of some pathological variables in rectal cancer survival.
Methods:
247 patients who underwent curative resection of rectal cancer were included in the study. The influence on survival of five pathological variables (histopathological tumor type, histopathological tumor grade differentiation, blood vessel invasion, perineural invasion and lymphatic invasion) was assessed using statistical analyses.
Results:
Overall 5-year survival was 71.2%. Univariate analysis of all tested variables showed an effect on survival but only the effect of lymphatic invasion was statistically significant. At stages three and four it had a negative effect on survival (P = 0.0212). Lymphatic invasion also significantly affected cancer related survival in multivariate analysis at stages three and four. At lower stages (stage 0, stage 1 and stage 2) multivariate analysis showed a negative effect of perineural invasion on cancer related survival.
Conclusion:
Patients with lymphatic and perineural invasion have a higher risk for rectal cancer related death after curative resection. Examination of these variables should be an important step in detecting patients with a poorer prognosis.