The Clinical Analysis Of Prognosis Of Patients With Colorectal Cancer After Surgery In Chengde

Objective:By analyzing the clinical,pathological and survival data of the patients with colorectal cancer(CRC)who were received in the gastrointestinal surgery department of Chengde Medical University Affiliated Hospital from November 2013 to November 2018 and operated in the undergraduate room to understand the clinical and pathological characteristics of CRC in Chengde and explore the prognostic factors of patients after CRC.In view of the influencing factors of the prognosis of CRC patients in our hospital,combined with the current medical situation in our hospital,to provide theoretical basis for the individualized diagnosis and treatment and precise treatment of patients in this area.Methods:Collect clinical and pathological data of 860 CRC patients who were first diagnosed and treated in our hospital for gastrointestinal surgery from November 2013 to November 2018,the follow-up deadline was December2019 or the time of patient death.All patients' medical records were established with Excel database,and SPSS 19.0 statistical software was used for statistical analysis of the database data.Univariate analysis was performed using the Kaplan-Meier method.The multivariable COX regression model was used to analyze the meaningful variables in the univariate analysis to determine the independent risk factors affecting the prognosis of CRC patients,and the postoperative survival status of patients under different factors was studied.Results:1 Descriptive analysisA total of 860 eligible CRC patients were collected in this study.Theaverage age of onset was 60.9 ± 10.3.The youngest patient was 26 years old and the oldest was 86 years old.There were 521 males(60.6%)and 339females(39.4%).Tumor lesions were located in 490 cases(57%)of the rectum,164 cases(20.1%)of the right half colon,and 206 cases(22.9%)of the left half colon.605 cases(70.3%)had blood as the first symptom,and 346(40.2%)had changes in bowel habits.260 patients(30.2%)had anemia before surgery.Stage III patients were the most in TNM staging,with 378 cases(44.0%),and liver metastasis was the most common in distant metastases,with 51 cases(5.9%).2 Subsistence analysis2.1 Total subsistence AnalysisSurvival analysis of 860 patients with CRC in our hospital showed that the survival rate was 93.0% at 365 days(1 year),83.0% at 1095 days(3 years),and 79.0% at 1825 days(5 years).2.2 Univariate Kaplan-Meier analysisUnivariate analysis showed that factors affecting the prognosis of patients with CRC include age(p<0.05),Smoking history(p<0.01),family history of tumor(p<0.01),tumor primary site(p<0.01),tumor diameter(p<0.01),depth of invasion(p<0.01),TNM stage(p<0.01),degree of differentiation(p<0.01)Lymph node metastasis(p<0.01)and distant metastasis(p<0.01).2.3 Multi-factor COX regression analysisMultivariate analysis of COX regression results showed that factors that had a significant effect on the prognosis of CRC patients included age(relative risk RR was 1.418,p<0.05),history of smoking(RR:2.837,p<0.01),family history of tumors(RR:3.907,p<0.01),tumor diameter(RR:2.293,p<0.01),depth of invasion(RR:2.860,p<0.01),TNM Staging(RR:1.679,p<0.01),lymph node metastasis(RR:2.302,p < 0.01),and distant metastasis(RR:12.016,p<0.01).Conclusion:1 CRC patients in Chengde area are more common in males,and the primary rectum is significant.The pathological differentiation is common inmiddle differentiation,the classification is common in ulcer type,the TNM stage is common in stage III,and the metastatic site is most common in liver metastases.Most of the patients' first symptoms were blood in the stool and changes in stool characteristics.2 The prognosis of patients with CRC is related to age,smoking history,tumor family history,tumor diameter,primary tumor location,lymph node metastasis,distant metastasis,depth of invasion,degree of differentiation,and TNM stage,etc.Tumor diameter,depth of invasion,TNM stage,lymph node metastasis,and distant metastasis were independent risk factors for CRC.