Risk Factors Analysis Of Recurrence And Metastasis For The Stage ?A Rectal Cancer After Radical Resction

ObjectiveThe purpose of this study was to investigate the risk factors of local recurrence and distant metastasis for the stage ?A(pT3N0M0)rectal cancer after radical resction.Methods and MaterialsThe clinicopathologic and follow-up date of patients with stage ?A(pT3N0M0)rectal cancer paitients treated with resection from January 2006 to January 2012 of Fujian Provincial Cancer Hospital were retrospectively analyzed.Completed date of 118 cases were collected according to the inclusion and exclusion criteria.46 cases of local recurrence and distant metastasis group were stage ?A rectal cancer patients with local recurrence and distant metastasis who had undergone radical resction form January 2006 to January 2012.And 72 cases of the control group were stage ?A rectal cancer patients who had undergone radical resction at the same time,which fulfille with follow-up of five years without local recurrence and distant metastasis.Including age,sex,course of disease,merger of the underlying disease,peroperative level of CEA,preoperative anemia,bowel obstruction,peroperative blood transfusion,surgical procedures,number of lymph nodes dissected,tumor location,gross type,tumor differentiation,tumor diameter,vascular or neural invasion,postoperative infection,postoperative chemotherapy and postoperative radiotherapy were noted down as the candidate risk factors.The design method of case-control study was used.Statistical analysis are carried out by SPSS software(version 21.0 for windows).We used single-factor analysis(chi-square test)and multi-factor analysis(Logistic regression)to investigate the features of the two groups.ResultsSingle-factor analysis showed that there were significant differences in age,peroperative level of CEA(CEA?5 ng/ml),bowel obstruction,number of lymph nodes dissected less than 12,gross type,tumor diameter,vascular or neural invasion,the absence of postoperative chemotherapy and the absence of postoperative radiotherapy between the two groups.The results of multivariate analysis showed that there were significant differences in peroperative level of CEA(CEA?5 ng/ml),bowel obstruction,number of lymph nodes dissected less than 12,the gross type is infiltration-ulcerative,tumor diameter >5cm,and the absence of postoperative chemotherapy between the two groups.ConclusionsPeroperative level of CEA(CEA?5 ng/ml),bowel obstruction,number of lymph nodes dissected less than 12,the gross type is infiltration-ulcerative,tumor diameter > 5cm and the absence of postoperative chemotherapy were regarded as the independent high risk factors of local recurrence and distant metastasis for the stage ?A rectal cancer after radical resction.