Rectum cancer: The effects of perioperative outcomes of patients as long-term prognostic factor
Rectum cancer: The effects of perioperative outcomes of patients as long-term prognostic factor
Aim: After cancer treatment, patients and clinicians expect accurate prediction of long-term prognosis. The aim of this study was todetermine which perioperative factors that may also be useful in determining long-term prognosis.Material and Methods: The data of rectum cancer patients operated on between 1998 and 2006 were retrospectively compared inrespect of clinicopathological and operative results, and long-term survival. Survival was calculated using a Kaplan-Meier method.Data thought to be associated with survival were subjected to univariate analysis followed by Cox proportion regression.Results: A total of 348 patients were included in the study. The mean age was 56 (±12) years in patients and 195 (56%) were malepatients. After retrospective evaluation of the database, the mean duration of disease-free survival was 54 (±50) months and themean duration of life was 60 (±48) months. There was no statistically significant correlation between gender, surgical procedure,histopathologic type of tumor, T level of the tumor, stage of the patient, ca 19-9 and mean life span. Grade, lymph node status andCEA were statistically correlated with survival time.Conclusion: We have demonstrated that grade, lymph node status and CEA are associated with long-term survival. These clinicalfactors are suitable to provide a good clinical guide to prognosis.
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- 1- Compton CC. Colorectal carcinoma: diagnostic, prognostic, and molecular features. Mod Pathol 2003;16:376-88.
- 2- How P, Shihab O, Tekkis P, et al. A systematic review of cancer related patient outcomes after anterior resection and abdominoperineal excision for rectal cancer in the total mesorectal excision era. Surg Oncol 2011;20:149–55.
- 3- köhler l, Eypasch e, Paul a, et.al. Mythys in management of colorectal malignancy. Br J Surg 1997;84:248- 51.
- 4- O’ connel jb, liu jh, livingstone ehk. Rates of colon and rectal cancers are increasing in young adults. Am Surg 2003;69:866-72.
- 5- Kockerling F, Reymond MA, Altendorf-Hofmann A, et al. Influence of surgery on metachronous distant metastases and survival in rectal cancer. J Clin Oncol 1998;16:324–9.
- 6- Singletary SE, Greene FL, Sobin LH. Classification of isolated tumor cells: clarification of the 6th edition of the American Joint Committee on Cancer Staging Manual. Cancer 2003 Dec 15;98:2740-1.
- 7- Mitry E, Benhamiche AM, Jouve JL, et al. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in well-defined French popülation. Dis Colon Rectum 2001;44:380-7.
- 8- Potter JD, Slattery ML, Bostick RM, Gapstur SM. colon Cancer:a review of the epidemiology .epidemiol Rev 1993;15:499-545.
- 9- Sabıston textbook of surgery18 th edition heidi nelson and robert r. clima chapter 51;1433-7.
- 10- Mekele J, Kiviniemi H, Laitinen S. Prognostic factors after surgery in patient younger than 50 years old with colorectal adenocarcinoma. Hepatogastroenterology 2002;49:971-5.
- 11- Chung YF, Eu KW, Machin D, et al. Young age is not poor prognostic marker in colorectal cancer. Br J Surg 1998;85:1255-9.
- 12- Mehrkhani F1, Nasiri S, Donboli K, et al. Prognostic factors in survival of colorectal cancer patients after surgery Colorectal Dis 2009;11:157-61.
- 13- Sabiston textbook of surgery18 th edition heidi nelson and robert r. clima chapter 51;1433-7.
- 14- Moghimi Dehkordi B, Safaee A, et al. Prognostic factors in 1,138 Iranian colorectal cancer patients. Int J Colorectal Dis 2008;23:683-8.
- 15- McCormack PM, Ginsberg RJ. Current management of colorectal metastases to lung. Chest Surg Clin North Am 1998;8:119-26.
- 16- Nelson RL, Dollear T, Freels S, et al. The relation of age, race, and gender to the subsite location of colorectal carcinoma. Cancer 1998;82:1408-10.
- 17- Pietra n, Sarli l, Sansebastiano g, et al prognostic value of ploidy, cell proliferation kinetcs and conventional clinicopathologic criteria in patients with colorectal carcinoma.a prospective study. Dis colon rectum 1996;39:494-503.
- 18- Burton S, Norman AR, Brown G, et al. Predictive poor prognostic factors in colonic carcinoma. Surg Oncol 2006;5:71-8.
- 19- American Cancer Society: Cancer Facts and Figures 2007. Atlanta, Ga: American Cancer Society, 2007. Also available online. Last accessed December 20,2007.
- 20- Hermanek P Prognosis of colorectal cancers Fortschr Med. 1991;109:187-8.
- 21- Enker WE, Havenga K, Polyak T, et al. Abdomino perineal resection via total mesorectal excision and autonomic nerve preservation for low rectal cancer. World J Surg 1997;21:215-20.
- 22- Suzuki O, Sekishita Y, Shiono T, et al. Number of lymph node metastases is beter predictor of prognosis than level of lymph node metastasis in patients with node-positive colon cancer. Am Coll Surg 2006;202:732-6.
- 23- Moran BJ. Stapling instruments for intestinal anasto¬mosis in colorectal surgery. Br J Surg 1996;83:902-9.
- 24- Chang GJ, Rodriguez-Bigas MA, Skibber JM, et al. Lymph node evaluation and survival after curative resection of coloncancer: systematic review. J Natl Cancer Inst 2007;99:433–41.
- 25- Park YJ, Park KJ, Park JG, et al. Prognostic factors in 2230 Korean colorectal cancer patients: analysis of consecutively operated cases. World J Surg 1999;23:721-6.
- 26- Cohen AM, Tremittera S, Candela F, et al. Prognosis of node positive colon cancer. Cancer 1991;67:1859-61.
- 27- Blumberg d, paty pb, Guillem jg,et al.all patients with small intramural rectal cancers are at risk for lymph node metastasis.dis colon rectum 1999;42;881-5.
- 28- Nascimbeni R, Burgart LJ, Nivatvongs S, et al. risk of Node Metastasis in the Colon and Rectum.dis colon rectum 2002;45:200-6.
- 29- Chen JS, Hsieh PS, Chiang JM, et al. Clinical outcome of signet ring cell carcinoma and mucinous adenocarcinoma of the colon. Chang Gung Med J 2010;33:51-57.
- 30- Han-Shiang C. Curative resection of colorectal adenocarcinoma: multivariate analysis of 5-year follow-up. World J Surg 1999;23:1301-6.
- 31- Reiter W, Stieber P, Reuter C, et al. Multivariate analysis of the prognostic value of CEA and CA 19-9 serum levels in colorectal cancer. Anticancer Res. 2000;20:5195-8.
- 32- Nozoe T, Rikimaru T, Mori E, et al. Increase in both CEA and CA 19-9 in sera as independent prognostic indicator in colorectal carcinoma. J Surg Oncol 2006;94:132-7.
- 33- Reiter W, Stieber P, Reuter C, et al. Preoperative serum levels of CEA and CA 19-9 and their prognostic significance in colorectal carcinoma. Anticancer Res 1997;17:2935-8.
- 34- Lavery IC, Lopez-Kostner F, Pelley RJ, et al. Treatment of colon and rectal cancer. Surg Clin North Am 2000;80:535- 70.
- 35- Newland RC, Chapuis PH, Pheils MT, et al. The relationship of survival to staging and grading of colorectal carcinoma: A prospective study of 503 cases. Cancer 1981;47:1424-9.