| خلاصه مقاله | Introduction: Colorectal cancer is a major cause of mortality in the worldwide. Rectal cancer (RC) accounts for approximately 30% of all colorectal cancer cases. The aim of this study was to determine the survival rates and define prognostic factors in RC patients. Methods: In this retrospective cohort study, 181 cases of RC were recorded from March 21, 2006, to 2011, and follow-up to 2017(cutoff date). Data were analyzed using the Kaplan-Meier method and log-rank test for the univariate analysis of survival in various subgroups. All significant factors that influenced the survival of patients were further analyzed in a multivariate analysis using Cox' regression and a value of p < 0.05 was set as statistically significant. Results: Of the 181 patients analyzed, 114 (63%) were males.
The mean age was 56.6 ± 15.2, ranging from 15 to 88 years. The most common presenting was hematochezia (66.9%). The mean tumor distance from the anal verge was 8.4 (SD, 4.6; range, 1–20) cm and the mean hemoglobin was 12.3 ± 1.9, (range, 6.6–15.8). 1, 3, 5 and 10-year survival rates were 81%, 54%, 44 %and 33%, respectively and median survival time was 39.1 ± 9.2 (CI 95% = 21.1-57.1) months. In the univariate analysis, place of residence (p = 0/009), education (p = 0/008), clinical presentation (p = 0/001), rectal obstruction (p = 0/006), Type of surgery (p = 0/001), treatment strategy (p = 0/001) and tumor stage (p = 0/001) were significant prognostic factors. Sex,
tumor distance from the anal verge, tumor differentiation did not show any significant effects on the survival rate. In multivariate analysis, tumor stage (p = 0/001) and treatment strategy (p = 0/001) were significant independent predictors of survival. Conclusion: In summary, the prognosis of rectal cancer in the North West of Iran is poor. Therefore, treatment strategy and early detection should be emphasized to improve survival. |