Prognostic factors in 2230 Korean colorectal cancer patients: Analysis of consecutively operated cases
Prognostic factors in 2230 Korean colorectal cancer patients: Analysis of consecutively operated cases
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DOI：
10.1007/pl00012376
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发表时间：
1999-07-01
影响因子：
2.6
通讯作者：
Kim, JP
中科院分区：
文献类型：
--
作者：
Park, YJ;Park, KJ;Kim, JP
为了明确韩国结直肠癌患者的预后因素，对首尔国立大学医院2230名连续接受结直肠癌切除术的患者的数据进行了单因素和多因素分析。影响预后的因素包括患者的年龄、性别、肠梗阻、出血、症状持续时间、术前白细胞计数、术前血清CEA水平、Dukes分期、肿瘤部位、肿瘤大小、肠壁侵犯深度、淋巴结转移数目、组织分化程度、肿瘤大体形态。总的5年生存率为62%。在单因素分析中，除性别、症状持续时间和肿瘤大小外，其他所有因素均与预后相关。在单因素分析中，Dukes分期(p<；0.001)、淋巴结转移数目(p<；0.001)、癌胚抗原水平(p<；0.001)、肿瘤部位(p=0.003)、肿瘤大体形态(p=0.017)、肠壁侵犯深度(p=0.031)在多因素分析中具有统计学意义。结肠癌和直肠癌的预后因素有几点不同。在多因素分析中，大体肿瘤形态仅对结肠癌有显著意义，组织分化仅对直肠癌有显著意义。淋巴结转移是结肠癌和直肠癌的独立预后变量，但其在直肠癌中的意义更为突出。虽然Dukes分期是最可靠的预后预测因素，但本研究表明，其他因素(术前CEA水平、肿瘤大体形态、肿瘤位置、淋巴结状况)也为患者的预后提供了重要信息。
To define the prognostic factors in Korean colorectal cancer patients, univariate and multivariate analysis were performed on data from 2230 consecutive patients who underwent resection for colorectal cancer at the Seoul National University Hospital. The prognostic variables used for the analysis included patient's age, gender, bowel obstruction, bleeding, symptom duration, preoperative Leukocyte count, preoperative serum carcinoembryonic antigen (CEA) level, Dukes' stage, tumor Location, tumor size, depth of bowel wall invasion, number of lymph node metastases, histologic differentiation, and gross morphology of tumor. The overall 5-year survival rate was 62%. In the univariate analysis, all the factors except sex, symptom duration, and tumor size were associated with prognosis. Among the factors significant in the univariate analysis, Dukes' stage (p < 0.001), number of Lymph node metastasis (p < 0.001), CEA Level (p < 0.001), tumor Location (p = 0.003), gross morphology of tumor (p = 0.017), and depth of bowel wall invasion (p = 0.031) were significant in the multivariate analysis. Several differences in prognostic factors between colon cancer and rectal cancer were observed. In the multivariate analysis, gross tumor morphology was significant only for colon cancer, and histologic differentiation was significant only for rectal cancer. Lymph node metastasis was an independent prognostic variable for both colon and rectal cancer, but its significance was more prominent for rectal cancer. Although Dukes' stage is the most reliable prognostic predictor, this study shows that other factors (preoperative CEA level, gross morphology of tumor, location of tumor, nodal status) also provide important information for the outcome of the patient.