title: Prognostic factors affecting recurrence and survival in patients with locally advanced rectal cancer.
abstract: OBJECTIVE
  This study aimed at investigating the factors that are likely to affect recurrence and survival in patients with locally advanced rectal cancer.
  
  
  METHODS
  The study included patients treated and followed- up between January 1999 and August 2009. Patient and disease data were retrieved from the patients' hospital charts.
  
  
  RESULTS
  A total of 221 patients were evaluated. Their median age was 58 years (range 18-83); 69 (31.2%) patients had clinical stage II and 152 (68.8%) clinical stage III. Median follow-up was 40 months (range 8-136). Median disease free survival (DFS) was 77 months and median overall survival (OS) 95 months. The factors affecting local recurrence were pathological lymph node involvement (pN+), pathological T4 (pT4) tumors, and postoperative high serum level of carcinoembryonic antigen (CEA). pN (+) tumors, postoperative high serum CEA level, and perineural invasion increased the risk of both local and distant metastasis. The factors affecting mortality were pN+ tumors, pT4 tumors, poor tumor differentiation, high postoperative CEA level, age > 60 years, and no postoperative adjuvant chemotherapy (CT). The factors affecting DFS were pN+ tumors, pT4 tumors, poor tumor differentiation, postoperative high serum CEA level, perineural invasion, and surgical margin positivity. The factors affecting OS were pN+ tumors, postoperative high serum CEA level, poor tumor differentiation, perineural invasion and no adjuvant CT.
  
  
  CONCLUSIONS
  Some prognostic factors are important in the assessment of prognosis of locally advanced rectal cancer.
authors: Dokuz Eylul University, Department of Internal Diseases, Izmir, Turkey. dogankoca@hotmail.com
authors: D
authors: D
authors: Koca
authors: C
authors: C
authors: Binicier
authors: I
authors: I
authors: Oztop
authors: T
authors: T
authors: Yavuzsen
authors: H
authors: H
authors: Ellidokuz
authors: U
authors: U
authors: Yilmaz
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen