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. 2009 Mar 14;15(10):1242-5.
doi: 10.3748/wjg.15.1242.

Prognostic factors for 5-year survival after local excision of rectal cancer

Dong-Bing Zhao  1 , Yong-Kai Wu, Yong-Fu Shao, Cheng-Feng Wang, Jian-Qiang Cai
Affiliations

Prognostic factors for 5-year survival after local excision of rectal cancer

Dong-Bing Zhao et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer, and to examine the therapeutic efficacy and surgical indications for this procedure.

Methods: Clinical data, obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005, were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier method, statistical comparisons were performed using the log-rank test, and multivariate analysis was performed using the Cox proportional hazards model.

Results: Transanal, transsacral, and transvaginal excisions were performed in 92, 12, and 2 cases, respectively. The rate of complication, local recurrence, and 5-year survival was 6.6%, 17.0%, and 86.7%, respectively. Univariate analysis showed that T stage, vascular invasion, and local recurrence were related to the prognosis of the cases (P < 0.05). Multivariate analysis showed that T stage [P = 0.011, 95% confidence interval (CI) = 1.194-3.878] and local recurrence (P = 0.022, 95% CI = 1.194-10.160) were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer.

Conclusion: Local rectal cancer excision is associated with few complications, and suitable for stages Tis and T1 rectal cancer. Prevention of local recurrence, active postoperative follow-up, and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.

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Figures

Figure 1
Figure 1
Survival curves for patients with different tumor T stages (A), different vascular invasions (B), and different local recurrence rates (C). The survival rate for the patients with T0 (n = 28), T1 (n = 48), T2 (n = 26), T3 (n = 4) varied significantly (P = 0.022). Patients without vascular invasion (n = 103) had a higher survival rate than those with vascular invasion. (n = 3) (P = 0.01). Patients without local recurrence (n = 88) had a higher survival rate than those with local recurrence (n = 18) (P = 0.005).
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