[Multivariate prognostic analysis of patients with low and middle rectal cancer after curative resection]

Abstract

Background & objective: The incidence of low and middle rectal cancer is high in China. Researches on improving treatment efficacy of this disease have constantly been concerned. This study was to evaluate the correlation of clinicopathologic features to the prognosis in low and middle rectal cancer.

Methods: The clinicopathologic data of 599 patients with low and middle rectal cancer, treated from 1990 to 1999 in Cancer Center of Sun Yat-sen University, were analyzed retrospectively. Curative resection was performed for all patients, including abdominoperineal resection (ARP, 355 cases) and low anterior resection (LAR, 244 cases). Survival rate was calculated using life table method, and differences between survival curves were tested by log-rank test. Cox regression model was used for multivariate prognostic analysis.

Results: The overall 5-year survival rate was 70.7%; it was significantly lower in APR group than in LAR group (67.5% vs. 75.2%, P=0.026). Univariate analysis showed that local recurrence, perioperative blood transfusion, lymph node metastasis, T stage, histology, macropathology, operation pattern, and distance from anal margin were correlated to prognosis (P<0.05). Multivariate analysis showed that local recurrence, perioperative blood transfusion, lymph node metastasis, and T stage were independent prognostic factors (P<0.01).

Conclusions: Local recurrence, perioperative blood transfusion, lymph node metastasis, and T stage are important prognostic factors of low and middle rectal cancer. LAR has become the preferred option in curative surgery for low and middle rectal cancer.