Factors about the feasibility of local excision of low rectal cancer / 肿瘤研究与临床

ABSTRACT

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.