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目的探讨直肠癌联合脏器切除术后复发、转移及预后的影响因素。方法选择河南省肿瘤医院2000年1月至2006年12月收治的97例直肠癌联合脏器切除的患者,根治性切除76例,分析根治性切除患者临的床病理因素与复发转移的关系,并对预后进行单因素及多因素分析;姑息性切除21例,比较根治性切除和姑息性切除对预后的影响。结果根治性切除组复发转移率为19.74%,单因素分析显示,性别、术前血清CEA水平、肿瘤活动情况、分化程度、Dukes,分期、淋巴结转移与术后复发转移有关;多因素分析显示,性别、肿瘤活动情况、分化程度、淋巴结转移与术后复发转移有关。根治性切除的2年生存率为90.78%,未能根治性切除的2年生存率为57.14%,差异有统计学意义。结论性别、肿瘤活动情况、分化程度和淋巴结转移是影响直肠癌联合脏器根治性切除患者术后复发转移的重要预后因素,根治性切除可以明显的提高2年生存率。
Objective To investigate the influencing factors of recurrence, metastasis and prognosis of rectal cancer combined with organ resection. Methods Ninety-seven patients with rectal cancer combined with organ resection from January 2000 to December 2006 in Henan Tumor Hospital were treated by radical resection in 76 patients. The relationship between clinical pathological factors and recurrence and metastasis in radical resection patients was analyzed. Univariate and multivariate analyzes were performed on prognosis. Palliative resection was performed in 21 patients. The effect of radical resection and palliative resection on prognosis was compared. Results The rate of recurrence and metastasis in radical resection group was 19.74%. Univariate analysis showed that gender, preoperative serum CEA level, tumor activity, differentiation, Dukes, stage and lymph node metastasis were related to postoperative recurrence and metastasis. Multivariate analysis showed that, Sex, tumor activity, differentiation, lymph node metastasis and postoperative recurrence and metastasis. The 2-year survival rate of radical resection was 90.78%, and the 2-year survival rate of failed radical resection was 57.14%. The difference was statistically significant. Conclusions Sex, tumor activity, differentiation and lymph node metastasis are important prognostic factors affecting the recurrence and metastasis of patients with rectal cancer combined with radical resection. Radical resection can significantly improve the 2-year survival rate.