Multivariate Analysis Of Prognostic Factors Of Colorectal Cancer After Radical Surgery By Cox Proportional Hazard Model

Objective:It is well known the most effective treatment for the patients with colorectal cancer were radical surgery at present.But a lot of factors affect the prognosis,including clinical and pathological aspects.In order to thoroughly understand the prognosis of the colorectal cancer,define the effective factors for clinical cure,this study summarizes our hospital material based on reviewing the literature of domestic and abroad,and analyses it by Cox proportional hazard model.Methods:According to the selection criteria,the data of 1863 hospitalized patients with colorectal cancer in Fourth Hospital of Hebei Medical University from January 1998 to December 2006 were reviewed.All the results of questionnaires were input to the EXCEL database.We randomly selected 764 cases from this database to study.A follow-up study was carried out by posting to or calling on the patients.The follow-up began from operation and ended with missing or lately follow-up.The termination of this study was defined as die of cancer.We selected thirteen potential factors of prognosis after having reviewed other studies for the purpose of defining influential factors.All analyses were performed by using SPSS 16.0.ANOVA was used for means comparison. Univariable and multivariable analysis were performed by Cox proportional hazard model.All tests were performed at 0.05 level of significance.Results:We randomly selected 764 cases to study,visited 667 cases and missed 97 cases,with lost rate 12.57%.The results of this study were in follows.1 In our study 403(52.75%) male and 361(47.25%) female were involved,the ratio of male and female is 1.116:1.2 The ages of patients in different annum had significant differences in the comparison(P<0.05),and the rage of ages in different annum spread wider and wider from 1998 to 2006.3 We analyzed thirteen factors of prognosis to definite its importance in the colorectal cancer patients\survival by using Cox proportional hazard model.On univariated analysis:course,pathological type,tumor diameter,operation,hepatic metastasis,colorectal wall invasion, tumor stage,lymphaden metastasis,metastasis stage influenced the prognosis significantly(P<0.05);sex,age,tumor location, treatment before surgery had no significances(P>0.05).On multiplicity analysis:course,pathological type, operation,colorectal wall invasion,lymphaden metastasis and metastasis stage were independent prognostic factors.4 Survival rate of the radical resection group were 0.916± 0.011,0.751±0.019,0.691±0.024 at 1,3,5 years.Conclusions:1 The independent factors of colorectal cancer\s prognosis are course,pathological type,operation,colorectal wall invasion, lymphaden metastasis and metastasis stage.2 The main factors associated with prognosis are tumor diameter, hepatic metastasis and tumor stage.3 Sex,age,tumor locationtr and treatment before surgery have no significances in prognosis.4 The ages of patients in different annum are different,and the rage of ages spread wider and wider from 1998 to 2006.5 The 1,3,5 years survival rate of this study are 91.6%,75.1% and 69.1%.