Multivariate Prognostic Analysis Of Patients With Stage Ⅱ Rectal Cancer After Curative Resection

Objective To analyze the dangerous factors of prognosis of stage II rectal cancer after curative resection and observe the curative effect of adjuvant chemotherapy.Methods 1. A retrospective analysis was performed on 78 cases of TNM-staging II rectal cancer patients, whom have been received curative surgery and diagnosed by postoperative pathology in our hospital during from January 2009 to February 2011.Analyze the basic information, tumor markers, tumor situation, treatment protocols, postoperative pathology, and postoperative recurrence and metastasis of them.2. Using the Kaplan-Meier method calculated the overall survival and disease-free survival of patients after curative surgery and making single factor analysis to determine the dangerous factors, and analyze these factors by Cox regression model for multivariate regression analysis to determine the independent dangerous factors of TNM-staging II rectal cancer patients after curative resection. 3. Compare the difference of overall survival and disease-free survival between the patients who received adjuvant chemotherapy and whom didn’t receive it.Results 1. 78 cases of TNM-staging II rectal cancer patients after curative resection, 1 year overall survival rate is 100%, 3 years overall survival rate is 93.3%, 5 years overall survival rate is 78.2%.1 year disease-free survival rate is 100%, 3 years disease-free survival rate is 85.3%, 5 years disease-free survival rate is 71.5%.2. The results of single factor analyze: Pre-operation CEA≥ 3.8 ng/ml, Preoperation CA199≥27U/ml, Pre-operation CA242≥20U/ml, Intestinal obstruction before operation, T4-stage after surgery and didn’t received adjuvant chemotherapy are the dangerous factors of prognosis of stage II rectal cancer after curative resection(P<0.05). 3. The results of multiple-factor analyze: Pre-operation CA199≥27 U/ml, intestinal obstruction before operation, T4-stage after surgery and didn’t received adjuvant chemotherapy are the independent dangerous factors of prognosis of stage II rectal cancer after curative resection(P<0.05). 4. The 1-year-os, 3-years-os, 5-years-os of patients who received adjuvant chemotherapy after curative resection is 100%, 100%, 92.9%.The 1-year-dfs, 3-years-dfs, 5-years-dfs of them is 100%, 93.1%, 86.4%. The 1-year-os, 3-years-os, 5-years-os of patients who didn’t receive adjuvant chemotherapy after curative resection is 100%, 87.0%, 62.5%. The 1-year-dfs, 3-years-dfs, 5-years-dfs of them is 100%,76.6%,54.7%.Conclusions Pre-operation CA199≥27 U/ml, intestinal obstruction before operation, T4-stage after surgery and didn’t received adjuvant chemotherapy are the independent dangerous factors of prognosis of stage II rectal cancer after curative resection. These patients can get prognostic benefit from adjuvant chemotherapy like FOLFOX or Cape OX, either of them included 5-FU and platina.