Dissertation
Dissertation > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Rectal cancer

The Study of the Correlation of Prognosis and Pattern Evaluation of Patients with Recurrence of Rectum Cancer

Author MaXueFeng
Tutor LiuGe
School Dalian Medical University
Course Surgery
Keywords Cancer Local recurrence Distant metastasis
CLC R735.37
Type Master's thesis
Year 2011
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Objective: To investigate the way cancer recurrence and prognosis of the correlation between in order to improve their therapeutic effect. Materials and Methods: from January 1995 to December 2008, First Affiliated Hospital of Dalian Medical University General Surgery row a total of 1490 cases of rectal cancer surgery, postoperative follow-up review 986 cases of patients, the first line of rectal cancer recurrence and metastasis in patients with 138 cases (approximately 14.00% of patients were followed up), select one of the 97 patients with complete data for the study. The above 97 cases were divided into two groups of local recurrence and distant metastasis, recurrence of rectal cancer patients with clinical features and prognosis data correlation. Result: 97 cases of relapsed patients were divided into two groups of local recurrence and distant metastasis, in which 43 patients with local recurrence group, accounting for 44.33%, the average recurrence interval of 19.78 months (3 to 60 months); distant metastasis 54 patients, accounting for 55.67%, the average recurrence interval of 15.73 months (2 to 64 months). Local recurrence and distant metastases in the two groups were gender, age, morphological type, histological type, depth of tumor invasion (T), the primary lesion site, the first operation mode, the recurrence time (years), serum CEA level, with or without intestinal obstruction contrast there was no significant difference was not statistically significant (P gt; 0.05), only in the lymph nodes (LN), Dukes staging contrast has significant difference was statistically significant (P lt; 0.05). Local recurrence and distant metastasis survival time after relapse patients were significant differences in comparison, with statistical significance (P = 0.015). Recurrence in 97 patients who underwent surgery again and only line chemotherapy were significant differences in comparison, with statistical significance (P = 0.001). Local recurrence patients (divided into anastomotic week, perineum and pelvic wall recurrence three subgroups) and distant metastasis patients (divided into the peritoneal group, liver metastasis, lung metastases, brain metastases, bone metastases other five sub-groups) between its various sub-groups comparison in survival time were no significant statistical difference was not statistically significant (P gt; 0.05), but again, local recurrence in patients who underwent surgery were performed with only chemotherapy there were significant differences, with statistical significance (P = 0.003). Cox regression analysis showed that patients with rectal cancer recurrence after initial surgery depth of tumor invasion, lymph node metastasis and recurrence after therapy is an independent prognostic factor of survival. Conclusions: 1, rectal cancer recurrence in patients with local recurrence and distant metastasis in patients with lymph node metastasis, Dukes stage was positively correlated; 2, the first surgery in patients with relapsed depth of tumor invasion, lymph node metastasis and recurrence after treatment prognostic factors; 3, conditions should be performed in patients with local recurrence of aggressive surgical treatment, can significantly improve the prognosis of patients.

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