应用COX比例风险模型对大肠癌切除术后预后影响因素的分析

目的探讨大肠癌手术切除后预后影响因素。方法对523例非手术死亡的大肠癌手术切除后患者进行研究。选择11个可能对大肠癌术后产生影响的特征性因素,通过计算机COX比例风险模型,利用累计生存率对大肠癌预后进行多因素分析。结果5年随访率为92.5%。全组3年生存率为57.2%,5年生存率为42.7%。结果表明,影响预后的主要因素是淋巴结转移、Duke’s分期、肿瘤侵袭深度、肿瘤长径和组织类型(P<0.0001)。结论大肠癌的淋巴结转移状况是手术切除术后影响预后的最重要因素,要提高生存率必须加强区域淋巴结的处理。

Study on Factors Influencing Survial in Patients with Colorectal Cancer after Resection by COX Proportional Hazard Model

Objective To study the prognotic factors in patients with colorectal cancer after curative resection. Methods 523 patients operated for colorectal cancer, who underwent a curative resection were included in this study. 11 possible factors influencing survial were selected.Amultivariate analysis of these individual variables. Results The follow-up rate was 92.5% over 5years. The over-all cumulative survival rate was 57.2% at 3 years, 42.7% at 5 years. The results showed that the major significant prognostic factors influencing survival of these patients were lymph modemetestases, Duke's stage, depth of invation, the long path of tumor and histologic type (P< 0.0001 ). Conclusion Lymph mode metasis is the most important prognostic factor for colorctal cancer after curative resection.Lymphadenectomy along with esophagectomy is necessary to impove survival rate.