OBJECTIVETo explore the clinicopathologic factors associated with prognosis in patients with rectal cancer.

METHODSClinicopathologic data of 2414 patients with rectal cancer, treated in the Affiliated Tumor Hospital of Harbin Medical University from May 1976 to December 2003, were analyzed retrospectively. Cox regression model was used to assess independent factors associated with prognosis.

RESULTSThe median survival time was 58 months and the 5-year overall survival rate was 45.1%. Tumors were stage I( in 75.2%, stage II( in 48.1%, stage III( in 21.3%, and stage Ⅳ( in 8.8% of the patients. The 5-year overall survival rates during the three study periods were 41.2%(1976-1986), 43.0%(1987-1996), and 49.1%(1997-2003)(P<0.01). On univariate analysis, age, time at diagnosis, histological type, distant metastasis, type of surgery, intent of surgery, gross morphology, pathologic T stage, lymphatic invasion, bowel obstruction, and TNM stage showed statistically significant association with survival. Independent prognostic factors on multivariable analysis were gross tumor morphology chi-squared value(CV):68.744, pT(CV:81.344), lymphatic invasion(CV:42.951), bowel obstruction(CV:37.856) and TNM stage(CV:85.329).

CONCLUSIONSSurvival in patients with rectal cancer is improved over time. TNM stage is the most important prognostic factor for survival in patients with rectal cancer.