Effectiveness Of Adjuvant Chemotherapy And Prognostic Factors Analysis In Postoperative Patients With Colorectal Cancer

Objective:Adjuvant chemotherapy for postoperative patients with colorectal cancer has been demonstrated to improve survival rate in series of randomized clinical trials in western countries. We therefore assessed the effectiveness of adjuvant chemotherapy in postoperative patients with colorectal cancer in our hospital and prognostic factors that Influence 3 year survival rate of colorectal cancer were also analyzed.Methods:138 postoperative patients with colorectal cancer were evaluated retrospectively. All patients received adjuvant chemotherapy in First Affiliated Hospital of Dalian Medical University during May 2001 to April 2006. All patients were followed up until May 2009. Kaplan-Meier survival curves were generated by SPSS 17.0 software for statistical analysis. Different groups divided according to adjuvant chemotherapy regimen and compare 3-year survival rate and 3-year disease-free survival. Univariate analysis and multivariate Cox model analysis is used to explore the impact factors of prognosis.Results:the median age was 58 years(from 31 to 76), male patients 94 cases (68.12%) and female 44 cases (31.88%). Primary tumor:proximal colon 27 cases (19.57%), distal colon 41 cases (29.71%) and rectum 70 cases (50.72%). Pathologic types:adenocarcinoma 110 cases (79.71%) and mucinous carcinoma 44 patients (31.88%).histological grade:well-differ-enttiated 35 cases(25.36%),moderately.differentiated in 64 patients (46.38%) and poorly differentiated 39 cases(28.26%),A mixed low-level classification of differentiation;. Clinical stage:stageⅡ51 patients (36.96%) and stageⅢ87 cases (63.04%). All the patients with adjuvant chemotherapy with 5-fluorouracil(5一Fu)／Leucovorin(CF)program in 57 cases(41.30％)or oxaliplatin(L-HP)combined 5-Fu／CF 81 cases(58.70％)6 cycles of chemotherapy.The whole group 138 patients,67 cases of recurrence and metastasis 3 years,3 years 39 patients died,3一year disease-free survival of 71 cases.3一year survival for all patients was 71.74％,3-year disease-free survival rate was 51.45％；Ⅱpatients with 3-year survival rate was 79.56％, 3-year disease-free survival rate was 58.46％；Ⅲpatients with 3 year survival rate of patients 65.67％,3一year disease-free survival rate was 47.83％；3-years survival rates of L-OHP+5-Fu／CF regimen group or 5-Fu／CF regimen group is 72.58％vs 69.46％(P=0.048) and 3-year disease-free survival rate is 62.96％vs 48.09％(P<0.01)；Ⅲpatients with sub-5-Fu／CF group and L-OHP+5-Fu／CF group,3-year survival rates were 64.79％vs 67.04％(P=0.083)no significant difference,3-year disease-free survival rates were 43.07％vs51.26％(P=0.031),statistically significant difference.Univariate analysis shows that pathological type,histological grade,clinical staging,adjuvant chemotherapy regimen and preoperative serum CEA level is important factors of 3-year overall survival rate. Multivariate analysis shows that pathologic type,histological grade, clinical staging is the independent factors of 3一year overall survival rate.Conclusion:L-OHP+5-Fu／CF regimen is effective in the adjuvant chemotherapy of postoperative patients with colorectal cancer,3-year disease-free survival rate can be improved,Ⅲpatients with 3-year disease-free survival rate was significantly prolonged thanⅡ.Pathologic type,histological grade,clinical staging is the independent factors of 3一year overall survival rate.