Analysis of the significance of local recurrence time for the prognosis of rectal cancer patients and its influencing factors
10.12354/j.issn.1000-8179.2024.20241290
- VernacularTitle:局部复发时间对直肠癌患者预后的意义及其影响因素分析
- Author:
Yang YANPENG
1
;
Wang WENPENG
1
;
Kong DALU
1
;
Wang JIEFU
1
Author Information
1. 天津医科大学肿瘤医院结直肠肿瘤科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市肿瘤防治重点实验室(天津市 300060)
- Publication Type:Journal Article
- Keywords:
locally recurrent rectal cancer(LRRC);
early recurrence(ER);
late recurrence(LR);
survival analysis
- From:
Chinese Journal of Clinical Oncology
2024;51(24):1261-1266
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The time to local recurrence of rectal cancer affects patient prognosis.Our study aimed to establish a clear threshold to distinguish between early and late recurrence and analyze their risk and prognostic factors.Methods:We conducted a retrospective se-lection and analysis of clinical data from 111 patients with locally recurrent rectal cancer(LRRC)who underwent proctectomy at Tianjin Med-ical University Cancer Institute&Hospital between January 2006 and December 2019.The minimum P-value approach and Log-rank test were used to determine the cut-off values of early recurrence(ER)and late recurrence(LR).Risk factors for early recurrence were analyzed using Logistic regression models,and prognostic factors associated with additional surgery were assessed using Cox proportional hazards models.Results:Based on the minimum P value approach,the optimal interval to distinguish early from late recurrence was 26 months(P<0.001).In the ER cohort,the median recurrence-free survival(RFS)was 14.1 months and post-recurrence survival(PRS)was 23.7 months.The median RFS of LR patients was 33.4 months,whereas the median PRS was 35.8 months.The 5-year survival rates in the ER and LR groups were 32.5%and 57.1%,respectively(P<0.001).In the univariate analysis,poor differentiation,positive lymph nodes,presence of lymphovascular invasion,and absence of radiotherapy enhanced the likelihood of early recurrence.Furthermore,only radiotherapy caused a significant difference in the multivariate analysis.Conclusions:Early recurrence of rectal cancer can be defined as recurrence within 26 months after radical surgery,and patients with early recurrence have a poorer prognosis.
