AIM:To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer,and to examine the therapeutic efficacy and surgical indications for this procedure. METHODS:Clinical data,obtained from...AIM:To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer,and to examine the therapeutic efficacy and surgical indications for this procedure. METHODS:Clinical data,obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005,were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier method,statistical comparisons were performed using the log-rank test,and multivariate analysis was performed using the Cox proportional hazards model. RESULTS:Transanal,transsacral,and transvaginal excisions were performed in 92,12,and 2 cases, respectively.The rate of complication,local recurrence, and 5-year survival was 6.6%,17.0%,and 86.7%, respectively.Univariate analysis showed that T stage, vascular invasion,and local recurrence were related to the prognosis of the cases(P<0.05).Multivariate analysis showed that T stage[P=0.011,95% confidence interval(CI)=1.194-3.878]and local recurrence(P=0.022,95%CI=1.194-10.160)were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer. CONCLUSION:Local rectal cancer excision is associated with few complications,and suitable for stages Tis and T1 rectal cancer.Prevention of local recurrence,active postoperative follow-up,and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.展开更多
OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of...OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of ampulla of Vater carcinoma.METHODS Clinical data from 105 patients who underwentradical pancreaticoduodenectomy from January 1990 to December2005 were retrospectively analyzed by the Kaplan-Meier method,log-rank test, and the Cox proportional hazard model.RESULTS The in-hospital mortality rate was 8.6%, the lymphnode metastasis rate was 37.1%, and the five-year survival ratewas 42.8%. Pancreatic involvement (P = 0.027), tumor diameter (P= 0.008), T stage (P = 0.003), TNM stage (P < 0.001), and number ofmetastatic lymph nodes (P < 0.001) were associated with prognosiswhen the univariate analysis was used. Multivariate analysisshowed that the number of lymph node metastases (P < 0.001;OR: 1.923; CI: 1.367-2.705) and tumor diameter (P = 0.03; OR: 1.432;CI: 1.035-1.981) were the independent prognostic factors.CONCLUSION The number of metastatic lymph nodes andtumor diameter are important pathologic factors predictingprognosis of ampulla of Vater carcinoma after radical resection,and lymph node dissection during the radical surgery effectivelyimproves the survival rate.展开更多
文摘AIM:To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer,and to examine the therapeutic efficacy and surgical indications for this procedure. METHODS:Clinical data,obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005,were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier method,statistical comparisons were performed using the log-rank test,and multivariate analysis was performed using the Cox proportional hazards model. RESULTS:Transanal,transsacral,and transvaginal excisions were performed in 92,12,and 2 cases, respectively.The rate of complication,local recurrence, and 5-year survival was 6.6%,17.0%,and 86.7%, respectively.Univariate analysis showed that T stage, vascular invasion,and local recurrence were related to the prognosis of the cases(P<0.05).Multivariate analysis showed that T stage[P=0.011,95% confidence interval(CI)=1.194-3.878]and local recurrence(P=0.022,95%CI=1.194-10.160)were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer. CONCLUSION:Local rectal cancer excision is associated with few complications,and suitable for stages Tis and T1 rectal cancer.Prevention of local recurrence,active postoperative follow-up,and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.
文摘OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of ampulla of Vater carcinoma.METHODS Clinical data from 105 patients who underwentradical pancreaticoduodenectomy from January 1990 to December2005 were retrospectively analyzed by the Kaplan-Meier method,log-rank test, and the Cox proportional hazard model.RESULTS The in-hospital mortality rate was 8.6%, the lymphnode metastasis rate was 37.1%, and the five-year survival ratewas 42.8%. Pancreatic involvement (P = 0.027), tumor diameter (P= 0.008), T stage (P = 0.003), TNM stage (P < 0.001), and number ofmetastatic lymph nodes (P < 0.001) were associated with prognosiswhen the univariate analysis was used. Multivariate analysisshowed that the number of lymph node metastases (P < 0.001;OR: 1.923; CI: 1.367-2.705) and tumor diameter (P = 0.03; OR: 1.432;CI: 1.035-1.981) were the independent prognostic factors.CONCLUSION The number of metastatic lymph nodes andtumor diameter are important pathologic factors predictingprognosis of ampulla of Vater carcinoma after radical resection,and lymph node dissection during the radical surgery effectivelyimproves the survival rate.
