进展期结直肠癌根治术后生存相关因素分析

Analysis of survival-related factors after radical resection of advanced colorectal cancer

目的探讨进展期结直肠癌根治术后影响生存的相关因素。方法回顾性分析2012年5月～2015年5月间133例进展期结直肠癌患者在本院行根治手术的患者资料,采用Cox比例风险模型分析影响术后生存的相关因素。结果在术后3年内共有35例患者死亡,3年总生存率为73.68%。Cox单因素分析提示术前CEA水平(P=0.0023)、肿瘤分化(P=0.0020)和肿瘤分期(P=0.0080)与术后长期生存明显相关。Cox多因素分析提示术前CEA水平(P=0.0103)、肿瘤分化(P=0.0149)和肿瘤分期(P=0.0291)与术后长期生存明显相关。结论术前CEA水平、肿瘤分化和肿瘤分期是进展期结直肠癌患者术后影响长期生存的危险因素,对具有危险因素的患者应加强随访,采用合理的术后辅助化疗方案以改善长期生存。

Objective To explore the related factors that affect survival after radical resection of advanced colorectal cancer.Methods The data of133patients with advanced colorectal cancer who underwent radical surgery in our hospital from May2012to May2015were retrospectively analyzed.Cox proportional hazards model was used to analyze the factors that affected the postoperative survival.Results A total of35patients died within3years after surgery.The3-year overall survival rate was73.68%.Cox univariate analysis revealed that preoperative CEA levels(P=0.0023),tumor differentiation(P=0.0020),and tumor stage(P=0.0080)were significantly associated with postoperative long-term survival.Cox multivariate analysis revealed that preoperative CEA levels(P=0.0103),tumor differentiation(P=0.0149),and tumor stage(P=0.0291)were significantly associated with long-term survival.Conclusion Preoperative CEA levels,tumor differentiation and tumor staging are risk factors for long-term survival in patients with advanced colorectal cancer after surgery.Patients with risk factors should be firmly followed up and treated with reasonable postoperative adjuvant chemotherapy to improve long-term survival.