Rectal cancer level significantly affects rates and patterns of distant metastases among rectal cancer patients post curative-intent surgery without neoadjuvant therapy

World Journal of Surgical Oncology

Research

Jinn Shiun Chen¹  Chien Yuh Yeh¹  Reiping Tang¹  Jeng Fu You¹  Pao Shiu Hsieh¹  Jy Ming Chiang² 

[1] Division of colorectal surgery, Department of surgery, Chang Gung Memorial Hospital, Lin-Kou medical center, and College of Medicine, Chang Gung University, No.5, Fu-Hsing St., 333, Kuei-Shan, Tao-Yuan, Taiwan;Division of colorectal surgery, Department of surgery, Chang Gung Memorial Hospital, Lin-Kou medical center, and College of Medicine, Chang Gung University, No.5, Fu-Hsing St., 333, Kuei-Shan, Tao-Yuan, Taiwan;College of Medicine, Chang Gung University, 333, Tao-yuan, Taiwan;

关键词: Overall Survival;    Rectal Cancer;    Lung Metastasis;    Anal Verge;    Rectal Cancer Patient;   

DOI  :  10.1186/1477-7819-12-197

 received in 2014-01-07, accepted in 2014-06-12,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundRectal cancer patients have a higher incidence of pulmonary metastases than those with colon cancer. This study aimed to examine the effects of rectal cancer level on recurrence patterns in rectal cancer patients.MethodsPatients with T3/T4 rectal cancers who underwent surgery between 2002 and 2006 were recruited in this study. All the patients were followed up on until death. Recurrence patterns and survival rates were calculated in relation to clinical variables.ResultsThere were 884 patients were enrolled in this study. Patients with low-rectal cancer had significantly worse five-year overall survival (OS) and disease-free survival (DFS) rates (47.25% and 44.07%, respectively) than patients with mid-rectal (63.46% and 60.22%, respectively) and upper-rectal cancers (73.91% and 71.87%, respectively). The level of the tumor (P <0.001), nodal status (P <0.001), tumor invasion depth (P <0.001), and tumor differentiation (P = 0.047, P = 0.015) significantly affected the surgical outcomes related to OS and DFS in the univariate and multivariate analyses. Furthermore, the level of the rectal cancer was a significant risk factor (hazard ratio 1.114; 95% CI, 1.074 to 1.161; P <0.001) for local recurrence, lung metastases, bone metastases, and systemic lymph node metastases. Significantly higher incidence rates of bone (53.8%) and brain metastases (22.6%) after initial lung metastases rather than initial liver metastases (14.8% and 2.9%, respectively) were also observed.ConclusionsFor rectal cancer patients who underwent surgical resection, the rectal cancer level significantly affected surgical outcomes including rates and patterns of distant metastases.

【 授权许可】

CC BY   
© Chiang et al.; licensee BioMed Central Ltd. 2014