Clinicopathological Characteristics and Prognostic Factors in Patients with Colorectal Cancer
|Course||Epidemiology and Biostatistics,|
|Keywords||Colorectal cancer Survival analysis Survival rate Cox proportional hazard model Prognosis|
Background and Objective:Colorectal cancer is a fatal disease with rapid increase in its incidence and mortality. In advanced western countries, its incidence occupies the second or third of all the malignant tumors, it also occupies the fourth or fifth in China. The aim of our research was to explore the clinicopathological features and prognostic factors, in order to serve the early diagnosis and treatment of the disease, thus improve the survival rate of patients.Materials and Methods:Retrospective analysis was made on the clinical data of 314 patients admitted in general surgery department of Qilu Hospital of Shandong University from January 2005 to December 2006. All data were recorded into an excel database. All the patients were followed up from operating day to the death from colorectal cancer.277 patients were successfully followed up, and the follow up loss rate was 13.44%. The exclusion standard was as follows:(1) refusal of being followed up by telephone or letter; (2) death caused by cardiac or pulmonary factors in a month after surgery. Survival data were calculated by SAS. Sex, age, stool blood, abdominal pain, tumor size, harvested lymph node, liver metastasis, local metastasis of lymph node, distant metastasis, tumor malignancy grade, infiltration depth of intestinal wall, TNM stage, operative modus, location of tumor, time of symptom emergence, preoperative diabetes, complicated diseases and so on were quantization, Cox proportional hazard model was used to conclude the independent factors that influenced prognosis. Kaplan-Meier and Log-rank were used to compare survival rate, P< 0.05 were regarded as of statistical significance.Results:There were 170 male patients and 107 female patients, and the ratio of male to female is 1.59:1.The age of the patients was from 18 to 86 years with mean age of 59.52±13.06, and the median was 60 years. The accumulative survival rate of 1 year and 3-year was 0.921±0.016 and 0.729±0.027,respectively.The univariate analysis revealed that Blood stool(P=0.042),tumor size(P<0.001), liver metastasis(P<0.001), local lymph node metastasis(P< 0.001), distant metastasis (P<0.001),malignant degree(P<0.001)infiltration depth(P=0.005), TNM stage(P< 0.001) were all of statistical significance (P<0.05). The multiple variates analysis revealed that malignant degree (P=0.004) and TNM stage III (P=0.002) were independent prognostic factors.Conclusions and Recommendation:Malignant degree and TNM stage were independent prognostic factors, also were the golden standard for the prognosis of colorectal cancer. Propaganda of the knowledge about cancer, improvement of consciousness about cancer prevention companied with screening system were all the radical methods for the early discovery, diagnosis and treatment of colorectal cancer, and improvement of survival rate of patients with colorectal cancer.