[Correlation of invasion, metastasis, and prognosis in low and middle rectal cancer].
OBJECTIVE
Several reports have showed that three histologic variables (venous invasion, regional lymph node status, and depth of primary tumor penetration) were associated with the prognosis of colorectal adenocarcinoma patients. Based on these variables, a new classification system has been recommended. This study was designed to evaluate prognostic significance and risk factors of neoplasm in low and middle rectal cancer.


METHODS
Four hundreds and eighty-four consecutive patients with low and middle rectal cancer were treated by the abdominoperineal resection (APR) (356 patients) and the low anterior resection(LAR) (128 patients) between 1990 and 1996. To determine the independent prognostic variables, the variables were evaluated both univariately and multivariately from the perspectives of oncologic outcome.


RESULTS
The 5-year survival rate for all patients was 71.1% (344/484), 63.5% (226/356) for APR and 92.2% (118/128) for LAR/SSR, respectively (P < 0.01). The resulting multivariate analysis using Cox regression showed that the three tumor variables were significantly associated with the 5-year survival (P < 0.01), the independent prognostic variables included venous invasion, tumor size, and TNM stages.


CONCLUSIONS
The three tumor variables identified in multivariate analysis as bearing the strongest independent effect on the 5-year survival in low and middle rectal cancer were (in order to decrease prognostic impact) venous invasion, tumor size, and TNM stages. These three tumor variables may be used as important bases for a new classification system.
He
Wei-jie
WJ
Department of General Surgery, Suzhou University Hospital, Suzhou 215006, P. R. China. hwj63321@pub.sz.jsinfo.net
Wang
Liang
L
Hu
Hao
H
Kang
Su-ya
SY
Qian
Hai-xin
HX
Xu
Feng-ming
FM
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate