摘要
目的:初步探讨影响以手术为主的综合治疗直肠癌的预后因素.方法:回顾性分析124例以手术为主的综合治疗直肠癌患者的临床资料.用Kaplan-Meier法计算生存率和局部控制率,Log-rank法作差异检验,多因素分析采用Cox比例风险模型.结果:所有患者的随访时间为7～81个月.本组病例的5年总生存率和局部控制率分别为30.6%和49.1%.单因素分析结果显示术后病理类型为腺癌、粘液腺癌和印戒细胞癌的患者5年生存率分别为44.9%,0%和0%(χ2=8.67,P=0.0129),5年局控率分别为55.2%,34.6%和33.3%(χ2=4.86,P=0.0334).行辅助放疗与未行辅助放疗者5年生存率分别为40.4%和13.3%(χ2=7.48,P=0.0062),5年局控率分别为73.5%和37.5%(χ2=29.68,P=0.0000).而Dukes分期,淋巴转移情况,肿瘤浸润肠壁深度,直肠系膜全切除(TME)以及术后辅助化疗等因素与预后无关(P＞0.05).多因素分析显示辅助放疗与病理类型是影响直肠癌患者生存率的独立预后因素(P=0.009和0.045),而对局部复发率进行多因素分析发现仅辅助放疗有统计学意义(P=0.0000).结论:对以手术为主的综合治疗直肠癌病例,肿瘤病理类型和是否辅以放射治疗是影响其预后的重要因素,其它因素尚不能肯定.
AIM： To evaluate the prognosis of rectal cancer treated with multimodality therapy based on surgery. METHODS： The clinical data of 124 rectal cancer patients treated with muhimodality therapy based on surgery were investigated and analyzed. Overall survival （OS） and loco-regional control （LC） rates were estimated by Kaplan-Meier method. Log-rank method and Cox proportional hazard model were used for identify the prognostic factors, respectively. RESULTS： The follow-up time ranged from 7 to 81 months. The 5-year OS and LC rates were 51.6% and 49.5%, respectively. Univariate analysis revealed that the 5-year OS of adencareinoma, mucinous adenocarcinoma and signet-ring cell carcinoma were 44.9%, 0% and 0%, respectively （X^2 = 8.67, P =0.0129）, the 5-year LC were 55.2%, 34.6% and 33.3%, respectively（X^2 =4.86, P =0.0334）. The 5-year OS of patients who accepted or not accepted adjuvant radiotherapy were, 40.4% and 13.3%, respectively（X^2=7.48, P =0.0062）, and the 5-year LC were 73.5% and 0%, respectively （ X^2 = 29.68, P = 0.0000）. Dukes stage, depth of infiltration, nodal, total mesorectal excision （TME）, and adjuvant chemotherapy were not correlated with the prognosis （ P 〉 0.05 ）. Multivariate analysis revealed that adjuvant radiotherapy and histology of tumor significantly affected the prognosis （ P = 0. 045 and P = 0.009, respectively）. Whereas loco-regional control was only significantly affected by adjuvant radiotherapy（ P = 0.000）. CONCLUSION： Adjuvant radiotherapy and histology of tumor are the important prognostic factors in the rectal cancer patients after treatment with multimodality therapy based on surgery.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2005年第7期819-823,共5页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
直肠肿瘤
手术治疗
放射疗法
药物治疗
预后因素
colorectal neoplasms/pathology
colorectal neoplasms/surgery
colorectal neoplasms/radiotherapy
colorectal neoplasms/drug therapy
prognostic factors
