The Study Of The Correlation Of Prognosis And Pattern Evaluation Of Patients With Recurrence Of Rectum Cancer

Objective:To investigate the relationship between the way recurrence of rectal cancer and prognosis.Methods:Collection data of 1490 patients that the diagnosis was primary rectal cancer in the First Affiliated Hospital of Dalian Medical University, General Surgery from Jan. 1995 to Dec. 2008. These were 986 cases of patients were follow up, 138 patients with recurrence after rectal cancer resection, and 97 cases that were finally diagnosed by pathology and with complete follow up data entered that study were retrospectively analyzed. Patients were divided into two groups:local recurrence(LR)and distant metastasis(DM).The clinicopathologic features,treatment strategies and prognosis were analyzed.Results:Among the 97 patients with recurrence,43(44.33%)were LR with a mean recurrence-free interval(RFI)of 19.78 months(3-60 months) and 54(55.67%)were DM with a mean RFI of 15.73 months(2-64 months). Compared with distant recurrence group , local recurrence group had no significant difference in gender, age, morphological type, histological type, depth of invasion(T), primary lesion site, the first surgical procedure type, recurrence time(Y), CEA and intestinal obstruction except for lymph node metastasis(LN) and Dukes stage. The post-recurrence survival was significantly different(P=0.015). There were no significant difference between surgical treatment group and conservative treatment group(P=0. 001). Post-recurrence survival were no different between subgroup of local recurrence and distant metastasis, but There were significant difference in subgroup of local recurrence(P=0.003). Cox regression analysis showed that depth of invasion(T),lymph node metastasis(LN) and treatment after recurrence were independently determining prognosis factors.Conclusions:1. Patients of rectal cancer with LR and DM were positively correlated with lymph node metastasis,dukes stage;2. Among the patients with recurrence,depth of invasion(T),lymph node metastasis(LN) and treatment after recurrence were prognostic factors;3. Radical surgery for recurrence can improve survival which patients of rectal cancer with LR.