<strong>Purpose:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">To identify clinical predictors for redu...<strong>Purpose:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">To identify clinical predictors for reduced long-term survival and </span><span><span style="font-family:Verdana;">describe the cause of death after surgical treatment for rectal cancer. </span><b><span style="font-family:Verdana;">Me</span></b></span><b><span style="font-family:Verdana;">thods:</span></b> <span style="font-family:Verdana;">A retrospective follow-up study of 442 consecutive, unselected patients</span><span style="font-family:Verdana;"> treated for rectal cancer at a tertiary centre from 1990 until 2000 and followed for 17 </span><span style="font-family:Verdana;">years or until death. Predictors for death were assessed by Cox regression</span><span style="font-family:Verdana;"> analysis. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">254 men and 188 women with a median age of 71 years (21 - 95 years) were resected for rectal cancer with low anterior resection (n = 266), abdominoperineal resection (n = 125), Hartmann’s procedure (n = 19) or diverting stoma only (n = 32). Median follow-up was 5 years (0 - 17 years). The relative five-year survival rates for stages I, II, III and IV was 83.9%, 65.2%, 41.1% and 9.3%, respectively. The proportion of deaths due to recurrence from colorectal cancer in stages I, II, III and IV was 23.5%, 55.8%, 72.3% and 98.0%, respectively. Heart, lung and cerebrovascular disease and other malignancies were the cause of death in the other patients. Higher age, </span><span style="font-family:Verdana;">abdominoperineal resection compared to low anterior resection, lack of</span><span style="font-family:Verdana;"> lymph node dissection compared to total mesorectal excision (TME), postoperative reoperations, TNM stages II and III compared to stage I and residual tumours after surgery were all significant independent predictors of reduced su展开更多
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatme...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatment </span><span style="font-family:Verdana;">of colon cancer are easily confounded by the modern adjuvant and</span><span style="font-family:Verdana;"> neo-adjuvant chemotherapy. This study focuses on lethality and survival during implementation of ultra-radical surgery for colonic cancer prior to multimodal therapy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Retrospective observational follow-up study of 824 consecutive, unselected patients resected for Stage I, II, III and IV colon cancer from 1990 until 2000 at one tertiary centre, with a median follow-up of 45 months (0 - 202 months). Predictors for death were assessed by Cox regression analyses and log-rank test. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The relative survival rates were 86.3%, 71.9%, 50.3% and 6.6% in Stage I, II, III and IV, respectively. In 28.7% </span><span style="font-family:Verdana;">of the patients, the cause of death was other than colorectal cancer recur</span><span style="font-family:Verdana;">rence. </span><span style="font-family:Verdana;">The adjusted Cox regression model showed that higher age (1.04 (95% CI:</span><span style="font-family:Verdana;"> 1.03;1.05)), male gender (1.37 (1.14;1.66)), emergency surgery (1.52 (1.21;</span><span style="font-family:Verdana;">1.93)), left vs. right hemicolectomy (1.39 (1.03;1.87)), and perioperative</span><span style="font-family:Verdana;"> blood transfusion (1.25 (1.01;1.55)) were predictors of reduced survival. Health without known comorbidity (0.71 (0.58;0.88)), D2 versus D1 lymph node dissection (0.66 (0.53;0.83)) and tumour Stage I, II, III versus Stage IV 0.10 (0.06;0.16), 0.14 (0.11;0.19), 0.23 (0.18;0.30) were associated with prolonged sur展开更多
文摘<strong>Purpose:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">To identify clinical predictors for reduced long-term survival and </span><span><span style="font-family:Verdana;">describe the cause of death after surgical treatment for rectal cancer. </span><b><span style="font-family:Verdana;">Me</span></b></span><b><span style="font-family:Verdana;">thods:</span></b> <span style="font-family:Verdana;">A retrospective follow-up study of 442 consecutive, unselected patients</span><span style="font-family:Verdana;"> treated for rectal cancer at a tertiary centre from 1990 until 2000 and followed for 17 </span><span style="font-family:Verdana;">years or until death. Predictors for death were assessed by Cox regression</span><span style="font-family:Verdana;"> analysis. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">254 men and 188 women with a median age of 71 years (21 - 95 years) were resected for rectal cancer with low anterior resection (n = 266), abdominoperineal resection (n = 125), Hartmann’s procedure (n = 19) or diverting stoma only (n = 32). Median follow-up was 5 years (0 - 17 years). The relative five-year survival rates for stages I, II, III and IV was 83.9%, 65.2%, 41.1% and 9.3%, respectively. The proportion of deaths due to recurrence from colorectal cancer in stages I, II, III and IV was 23.5%, 55.8%, 72.3% and 98.0%, respectively. Heart, lung and cerebrovascular disease and other malignancies were the cause of death in the other patients. Higher age, </span><span style="font-family:Verdana;">abdominoperineal resection compared to low anterior resection, lack of</span><span style="font-family:Verdana;"> lymph node dissection compared to total mesorectal excision (TME), postoperative reoperations, TNM stages II and III compared to stage I and residual tumours after surgery were all significant independent predictors of reduced su
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatment </span><span style="font-family:Verdana;">of colon cancer are easily confounded by the modern adjuvant and</span><span style="font-family:Verdana;"> neo-adjuvant chemotherapy. This study focuses on lethality and survival during implementation of ultra-radical surgery for colonic cancer prior to multimodal therapy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Retrospective observational follow-up study of 824 consecutive, unselected patients resected for Stage I, II, III and IV colon cancer from 1990 until 2000 at one tertiary centre, with a median follow-up of 45 months (0 - 202 months). Predictors for death were assessed by Cox regression analyses and log-rank test. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The relative survival rates were 86.3%, 71.9%, 50.3% and 6.6% in Stage I, II, III and IV, respectively. In 28.7% </span><span style="font-family:Verdana;">of the patients, the cause of death was other than colorectal cancer recur</span><span style="font-family:Verdana;">rence. </span><span style="font-family:Verdana;">The adjusted Cox regression model showed that higher age (1.04 (95% CI:</span><span style="font-family:Verdana;"> 1.03;1.05)), male gender (1.37 (1.14;1.66)), emergency surgery (1.52 (1.21;</span><span style="font-family:Verdana;">1.93)), left vs. right hemicolectomy (1.39 (1.03;1.87)), and perioperative</span><span style="font-family:Verdana;"> blood transfusion (1.25 (1.01;1.55)) were predictors of reduced survival. Health without known comorbidity (0.71 (0.58;0.88)), D2 versus D1 lymph node dissection (0.66 (0.53;0.83)) and tumour Stage I, II, III versus Stage IV 0.10 (0.06;0.16), 0.14 (0.11;0.19), 0.23 (0.18;0.30) were associated with prolonged sur
