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目的探讨直肠癌根治术后远期效果和影响手术疗效的相关因素。方法收集和分析1990年1月至1999年12月689例根治性切除直肠癌患者的资料。结果全组手术死亡率0.7%,随访率96.7%,术后1、3、5、10年生存率分别为89.9%、77.3%、69.6%和63.3%,中位生存期为67.4个月。单因素分析显示,直肠癌术后生存率与首发症状、肿瘤位置、肿瘤侵犯肠管周径比例、大体类型、组织类型、侵犯肠壁深度(T分期)、淋巴结转移的范围、Dukes分期和术式等因素相关。采用Cox多因素回归分析,结果显示仅肿瘤位置、组织类型、侵犯肠壁深度及Dukes分期是直肠癌根治术后长期生存的独立影响因子。结论直肠癌根治术后远期疗效与肿瘤位置、组织类型、侵犯肠壁深度及Dukes分期相关。
Objective To investigate the long-term effect of radical resection of rectal cancer and the related factors that influence the curative effect. Methods The data of 689 patients with radical resection of rectal cancer from January 1990 to December 1999 were collected and analyzed. Results The overall mortality was 0.7% and the follow-up rate was 96.7%. The 1, 3, 5 and 10-year survival rates were 89.9%, 77.3%, 69.6% and 63.3% respectively. The median survival time was 67.4 months. Univariate analysis showed that postoperative survival rate of patients with rectal cancer and the first symptom, tumor location, tumor invasion of intestinal circumference ratio, general type, histological type, invasion of intestinal wall depth (T stage), lymph node metastasis, Dukes staging and operation Related factors. Cox multivariate regression analysis showed that location of tumor, type of tissue, depth of invasion of bowel wall and Dukes staging were independent risk factors for long-term survival after radical resection of rectal cancer. Conclusion The long-term curative effect of radical resection of rectal cancer is related to the location of tumor, the type of tissue, the depth of invasion of intestinal wall and the Dukes stage.