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.

___

  • 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.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Is MR imaging correlated with mid-term clinical results after arthroscopic all-inside meniscal repair?

Soner AKKURT, Serap DOĞAN, Ahmet GÜNEY, Erdal UZUN

Are sternum fractures really indicative of severe trauma?

Murat KURU, Tuba ŞAHİNOĞLU

The importance of estrogen-α and progesterone immunohistochemical staining expression in patients with papillary thyroid carcinoma

Betul PEKER CENGİZ

The effects of diabetes mellitus on peri-implant marginal bone loss in the posterior maxilla

Mustafa KARACA, Mustafa Ozay USLU, Arife SABANCI

Evaluation of periostin levels in gingival crevicular fluid and peri-implant sulcus fluid in patients with periodontal and peri-implanter disease: A cross-sectional study

Meral UZUNKAYA

Zone 2 flexor tendon injuries: Our experience with early active movement protocol for rehabilitation of tendons

Mohammad Kamran KHAN, Mohammed Fahud KHURRAM, Arshad Hafeez KHAN, Nazia Umme HABIBA, Madhav CHOWDHRY

Risk factors for axillary lymph node metastasis in breast cancer

Uzer KÜÇÜKTULU, Eray KURNAZ, Huseyin EKEN, Bilgin ÇELEBİ

Investigation of the relationship between smartphone addiction and overweight on university students

Deniz Adnan ÇOBAN

The comparison of vacuum assisted closure (VAC) and conventional treatment methods in postpneumonectomy empyema cases

Özgür Ömer YILDIZ, Göktan TEMİZ, Nurettin KARAOĞLANOĞLU, Ömer Cenap GÜLYÜZ, İlknur Aytekin ÇELİK

Are unresponsive dilated pupils an indicator for brain death? an evaluation of Edinger Westphal nucleus in rabbits with brain death

Canan ATALAY, İlker İNCE, Mehmet AKSOY, Ebru ŞENER, Ayşenur DOSTBİL, Mehmet Dumlu AYDIN, Özgür ÖZMEN