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7 - The analysis of the prognostic factors affecting survival after the curative resection in patients with rectal cancer
Medeni Şermet, Fevzi Celayir, Adil Baykan
Objective: In this study we investigate the effects of the prognostic factors on the patients life expectancy whom underwent surgery for rectal cancer.
Methods: Between January 2004-December 2010, 112 patients were operated for rectal cancer at Şişli Etfal Traning and Reserach Hospital, FirstGeneral Surgery Clinic. 80 patients underwent curative resection. Their clinical records were retrospectively reviewed.
Age, gender, body mass index, operation type, tumor location, tumor size, macroscopic type, tumor stage (TNM classification), histological type and degree of differentiation, circumferential resection margin (CRM), vascular invasion, perineural invasion, lymph node involvement, preoperative neoadjuvant therapy, postoperative adjuvant therapy, preoperative tumor markers, CEA (N:0,0-3, 0), CA19-9 (N: 0-35U / ML), hemoglobin, serum albumin levels were identified as prognostic parameters. Their effects of 5-year survival were evaluated.
Results: There were 42 males and 38 females, mean age 57.8±11.0 years (age 20-79, Patient data were analyzed by univariate analysis. Patients who had extensive involvement of the rectum, tumor size larger than 5 cm, stage III-IV tumors, CRM positive, perineural and vascular invasion, lymph node positive, with high preoperative CEA levels according to the WHO classification and Malignant Melanoma or squamous cell carcinoma were short survival times. These factors were found to be independent prognostic factors were investigated by logistic regression analysis.
Conclusion: In our study, extensive involvement of the rectum, tumor size, tumor stage, perineural and vascular invasion, number of positive lymph nodes, CEA levels, positive CRM and tumor histological type were found to be independent prognostic factors. However, the effects of these parameters on survival should be more clearly. Therefore, it needs to increase the number of our patients and also the early stage patients and standardization of the surgical technique is required.
Keywords: Rectal cancer, prognostic factors
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