Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum

  • Authors:
    • Bartlomiej Szynglarewicz
    • Rafal Matkowski
    • Jozef Forgacz
    • Marek Pudelko
    • Zbigniew Smorag
    • Jacek Dryl
    • Jan Kornafel
  • View Affiliations

  • Published online on: February 1, 2007     https://doi.org/10.3892/or.17.2.471
  • Pages: 471-475
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The aim of the study was to estimate the long-term results and the prognostic value of clinical and pathological factors following R0 anterior resection with total mesorectal excision (TME). Ninety-eight consecutive patients with histologically confirmed rectal cancer were studied prospectively with five-year follow-up. Survival was calculated using the Kaplan-Meier method and differences between curves were tested by the log-rank test. Multivariate analysis was performed using the Cox regression model. Recurrence-free survival (RFS) was 63.6%. Mean time of recurrence was 13.8 months (range 3-38). Local recurrence rate was 7.8% with the mean time of 12.7 months (range 3-25). In univariate analysis Dukes' stage (RFS for stage: A=93.2%; B=53.8%; C=26.3%) and preoperative CEA serum level (s-CEA) (for s-CEA ≤5 ng/ml RFS=93.8%; for s-CEA >5 ng/ml RFS = 5.9%) significantly influenced survival (P<0.005 and P<0.00001). These parameters were also found to be independent prognostic factors in multivariate analysis (P<0.05 and P<0.00001). Survival was worse in older female patients with low-localised poorly differentiated tumors; however, those variables had not significant impact on prognosis. Neither symptom duration nor mucinous histology was significantly related to survival. Using TME technique a low local recurrence rate resulting in improved survival can be achieved. Apart from clinicopathological staging, elevated s-CEA can identify patients with poor prognosis. In addition to TME adjuvant therapy for this high-risk group should be considered.

Related Articles

Journal Cover

February 2007
Volume 17 Issue 2

Print ISSN: 1021-335X
Online ISSN:1791-2431

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Szynglarewicz B, Matkowski R, Forgacz J, Pudelko M, Smorag Z, Dryl J and Kornafel J: Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum. Oncol Rep 17: 471-475, 2007.
APA
Szynglarewicz, B., Matkowski, R., Forgacz, J., Pudelko, M., Smorag, Z., Dryl, J., & Kornafel, J. (2007). Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum. Oncology Reports, 17, 471-475. https://doi.org/10.3892/or.17.2.471
MLA
Szynglarewicz, B., Matkowski, R., Forgacz, J., Pudelko, M., Smorag, Z., Dryl, J., Kornafel, J."Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum". Oncology Reports 17.2 (2007): 471-475.
Chicago
Szynglarewicz, B., Matkowski, R., Forgacz, J., Pudelko, M., Smorag, Z., Dryl, J., Kornafel, J."Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum". Oncology Reports 17, no. 2 (2007): 471-475. https://doi.org/10.3892/or.17.2.471