结、直肠癌术后复发和生存因素分析

Analysis of patterns of recurrence and factors affecting survival following curative surgery plus adjuvant and neoadjuvant therapy for patients with colorectal cancer

目的 :通过对结、直肠癌术后复发病例的分析 ,探讨治疗失败的原因及其治疗对生存因素的影响。 方法 :对 2 0 9例 B期和 C期的结、直肠癌患者治疗 ,经 5年的随访研究 ,6 8例出现复发和转移 ,分析复发的部位、原因及其与治疗的关系。应用多元回归的 Cox风险比例模型分析对结、直肠癌生存率的影响因素。 结果 :总复发率为 32 .5 %。肝转移 2 5例 ,占 1 3.4% ,其次为原位复发、腹膜转移和腹腔外转移。Cox模型分析 ,术前加术后辅助化疗组较单纯手术组复发的相对风险减少了 42 % ,死亡的相对风险减少了 36 %。 结论 :不同的辅助治疗方式和 Dukes分期为独立的预后判断指标 ,手术前、后的辅助治疗能减少结。

Objectives:To study factors affecting recurrence and survival in 209 patients after curative resection of colorectal cancer plus pre and postoperative adjuvant therapy. Methods:Two hundred and nine patients with colorectal cancer were followed up for 5 years after curative operation and adjuvant therapy. Multivariate factors were analyzed in relapsed and metastatic cases by means of the Cox proportional-hazards model. Results:Sixty-eight recurrent and metastatic cases were found in 209 patients(32.5%).The rate of liver metastasis is higher than other sites, such as original location, abdominal peritoneum and places outside the abdominal cavity. The relative hazardous factors of recurrence and death decreased by 42% and 36% respectively. Conclusions:The methods of treatment and Dukes stages were the independent predictors. The compatible therapy combined curative surgery with pre and postoperative adjuvant therapy could reduce recurrent rate in liver and local sites in patients with colorectal cancer.