title: Risk factors for survival after colorectal cancer resection.
abstract: OBJECTIVE
  To describe survival rates and prognostic factors for colorectal cancer (CRC) operated in a district general hospital setting with a special focus on the number of lymph nodes examined.
  
  
  METHODS
  Between December 2004 and December 2006, a total of 277 CRC patients who underwent surgical treatment in QHSU were included. All patients were followed up intensively from discharge until death or the end of the follow-up (December 31, 2010).
  
  
  RESULTS
  The median follow-up period was 53 months (range, 1-72 months). Overall 3-year survival was 72.9%. In only 11.5% of the specimens were 12 or more lymph nodes retrieved, but this did not affect survival. A multivariate analysis identified that the significant prognostic factors were TNM stage III [adjusted hazard ratio (HR): 5.49; 95%CI: 1.64-18.41], TNM stage IV (adjusted HR: 7.55; 95%CI: 2.12-26.84), tumor histology (adjusted HR: 1.88; 95%CI: 1.16-3.04), hospital stay (adjusted HR: 1.03; 95%CI: 1.00-1.06) and lymph node ratio (LNR) (adjusted HR: 3.92; 95%CI: 1.79-8.55) for stage III.
  
  
  CONCLUSIONS
  TNM stage, tumor histology and the length of hospital stay could prominently affect outcome overall. The lymph node count did not have a significant impact on survival, whereas the LNR proved significant for stage III. Nevertheless, a protocol using overall lymph node yield as a surrogate measure for more radical surgery seems warranted to improve the lymph node resected.
authors.affiliation: Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
authors.forename: Bin-Bin
authors.initials: BB
authors.lastname: Zhang
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Chen
authors.forename: Qi-Zhen
authors.initials: QZ
authors.lastname: Wei
authors.forename: Guo-Chang
authors.initials: GC
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
mesh_terms: D002454:Cell Differentiation; D002681:China; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome