58例直肠癌病例的预后分析

The Prognostic Analysis of Fifty-eight Patients with Rectal Cancer

目的观察直肠癌病例接受综合治疗后的长期疗效,并分析影响其预后的因素。方法回顾性调查苏州大学附属第二医院自2000年至2005年收治的58例直肠癌患者的临床资料,并随访其治疗的长期疗效。结果所有患者3年和5年的局部控制率分别为81.1%和75.0%,总生存率分别67.2%和61.7%,肿瘤特异性生存率分别为72.2%和69.1%;单因素分析结果显示Dukes分期为A、B和C期患者的5年局部控制率分别为84.0%、62.9%和61.4%(P=0.048),5年总生存率分别为93.3%、54.7%和20.0%(P=0.000),5年肿瘤特异性生存率分别为93.3%、72.4%和29.2%(P=0.000);无和有盆腔淋巴结转移患者的5年局部控制率分别为75.7%和61.4%(P=0.024),总生存率分别为76.0%和20.0%(P=0.000),肿瘤特异性生存率84.2%和29.2%(P=0.000)。而性别、年龄、是否接受放疗和/或化疗对其预后的影响则均无显著的统计学意义(P>0.05)。结论直肠癌治疗的长期疗效较好,病期的早晚和是否存在盆腔淋巴结转移是影响其预后的重要因素。

Objective To investigate the long-term outcomes of patients with rectal cancer who received multi-modality therapies and to evaluate the prognostic factors.Methods The clinical data of fifty-eight patients with rectal cancer in the Second Affiliated Hospital of Soochow University from 2000 to 2005 was reviewed retrospectively.Results The 3-and 5-year local control rates of all patients were 81.1% and 75.0%,the overall survival rates were 67.2% and 61.7%,and the cause-specific survival rates were 72.2% and 69.1%,respectively.The Kaplan-Meier analysis showed that the 5-year local control rates of Dukes A,B and C stage were 84.0%,62.9% and 61.4%（P=0.048）,the overall survival rates were 93.3%,54.7% and 20.0%（P=0.000）,and the cause-specific survival rates were 93.3%,72.4% and 29.2% respectively（P=0.000）.The 5-year local control rates with or without lymph metastasis were 61.4% and 75.7%（P=0.024）,the overall survival rates were 20.0% and 76.0%,and the cause-specific survival rates were 29.2% and 84.2%（P=0.000） respectively.However,gender,age,chemotherapy and/or radiotherapy were not prognostic impact in these patients.Conclusion The long-term prognosis of patients with rectal cancer is satisfied,and Dukes stage and lymph node metastasis have prognostic significance in rectal cancer.