Surgical strategy for patients with stage Ⅳ rectal cancer / 中华普通外科杂志

ABSTRACT

Objective To investigate the surgical treatment and indications for primary lesion in patients with stage Ⅳ rectal cancer.nethods Clinical data of 118 patients with stage Ⅳ rectal cancer undergoing surgical treatment from January 1988 to December 2005 in Cancer Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively using Statistical Package for the Social Sciences(Release 13.0,SPSS,Inc).Survival was estimated using the Kaplan-Meier method and compared using the log-rank test.Cox regression was used in multivariate analysis.Results One hundred and five of 118 patients received rectal primary lesion resection,including 16 cases with simultaneously metastatic tumor resection.13 of 118 patients received ostomy.The overall 5-year survival rate of the primary lesion resection group was 8.57%,the 5-year survival rate of the metastatic tumor resection group was 31.2%.The median survival in the primary lesion resection group and the ostomy group was 15 months and 13 months respectively(X2=0.736.P=0.778).Multivariate analysis showed that degree of differentiation of primary tumor,maximal diameter of liver metastasis and chemotherapy were the most important prognostic factor of the primary tumor resection group.Conclusion Simultaneous resection of primary and metastatic tumor can prolong suivival time of patients with resectable stage Ⅳ rectal cancer.