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目的探讨直肠癌根治术后局部复发和远位转移的影响因素。方法对412例直肠癌患者资料进行复习,其中378例根治术病例加以研究,对于影响直肠癌预后的20个可能相关因素,使用Cox模型进行分析。结果手术切除率91.7%(378/412),手术组中根治切除率为94.7%(358/378)。术后5 a生存率47.6%(180/378)。至2006年底121例术后复发转移,其中局部复发47例,肝转移41例,肺转移9例,骨转移3例;2个以上的同时转移10例,癌肿转移部位不明而死亡者11例。结论直肠癌根治性切除术后局部复发和远位转移的影响因素有6个,依次为分期、原发瘤大小、侵犯深度、淋巴结转移情况、组织分型、大体分型,其余4个因素:病期、肿瘤占据肠腔周径、肿瘤下缘距肛门齿状线的高度和年龄也有一定影响。
Objective To investigate the influencing factors of local recurrence and distant metastasis after radical resection of rectal cancer. Methods The data of 412 cases of rectal cancer were reviewed. Among them, 378 cases of radical resection were studied. For the 20 possible related factors affecting the prognosis of rectal cancer, the Cox model was used for analysis. Results The resection rate was 91.7% (378/412). The radical resection rate in the surgery group was 94.7% (358/378). The 5-year survival rate after surgery was 47.6% (180/378). By the end of 2006, 121 cases had recurrence and metastasis, including 47 cases of local recurrence, 41 cases of liver metastases, 9 cases of lung metastases, 3 cases of bone metastases, 2 cases of simultaneous metastases, and 10 cases of metastases with unknown metastasis. . Conclusion There are 6 factors influencing the local recurrence and distant metastasis after radical resection of rectal cancer. They are stage, primary tumor size, depth of invasion, lymph node metastasis, histological type, and gross classification. The other 4 factors are: The disease period, tumor occupying the perimeter of the intestine, and the height and age of the anterior dentate line from the lower edge of the tumor also have a certain effect.