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  • Title: [Factors affecting the prognosis and selection of local excision for low rectal cancer].
    Author: Hang JW, Zhou ZX, Bu YQ, Bai XF, Wang X, Zhao P.
    Journal: Zhonghua Zhong Liu Za Zhi; 2007 Feb; 29(2):141-3. PubMed ID: 17645854.
    Abstract:
    OBJECTIVE: To investigate the factors affecting the result and selection of local excision for low rectal cancer. METHODS: The clinical data of 101 patients with low rectal cancer treated by local excision were retrospectively analyzed. Survival was estimated using the Kaplan-Meier. The factors influencing on the survival were analyzed using univariate (Log rank) and multivariate (Cox model) analysis methods. RESULTS: Of 101 patients in this series, 91 patients underwent transanal excision, 9 had transsacral excision, 1 recieved transvaginal excision. Postopertative complication developed in 6 patients (5.9%). No death occurred within 30 postoperative days. Five T4 patients underwent preoperative radiotherapy, and 34 received postoperative radiotherapy. The overall 5-year survival rate was 91.0% for the whole group, and it was 100%, 92.6%, 77.1%, 83.3% for patients with Tis, T1, T2, and T3/T4 lesion, respectively. The incidence of local recurrence was 15. 8%. Univariate analysis revealed that pathological T stage, tumor size (> 3 cm), lymphovascular invasion, ulcerative lesion, adjuvant radiotherapy and local recurrence were significant factors affecting the survival (P <0.05). However, by multivariate analysis, only tumor size ( > 3 cm) and local recurrence were found to be the significant prognostic predictors. CONCLUSION: The important selection criteria for local excision in the treatment of low rectal cancer may include T1 stage, well or moderate differentiation,tumor size < or = 3 cm, no lymphovascular invasion.
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