چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| سید کاظم میری نژاد | اول |
| محمد حسین صومی | دوم |
| عنوان | متن |
|---|---|
| کلمات کلیدی | Keywords: Locally advanced rectal cancer; Recurrence; Survival; Prognostic factor; Disease-free survival |
| خلاصه مقاله | Background: Despite advances in multimodal treatment, recurrence remains a major challenge in patients with locally advanced rectal cancer (LARC) and significantly impacts survival outcomes. Identifying clinicopathologic (CP) factors associated with recurrence and disease-free survival (DFS) may help optimize surveillance strategies and improve long-term outcomes. Methods: This retrospective cohort study included 339 patients with LARC who underwent curative surgery followed by neoadjuvant (NCRT) or adjuvant chemoradiotherapy (ACRT). CP variables such as age, sex, tumor differentiation, clinical stage, and treatment modality were analyzed. DFS was assessed using Kaplan–Meier analysis, with comparisons by log-rank test, and independent predictors were evaluated using Cox proportional hazards regression. Results: The cohort consisted of 193 men and 146 women, with a median age of 59 years and a median follow-up of 38 months. Most tumors were well differentiated (77.9%), and over half of patients presented with localized disease. Recurrence occurred in 16.2% of patients, with local recurrence slightly more frequent than distant recurrence. Female patients experienced significantly higher recurrence rates than males (21.2% vs. 12.4%, p<0.05), while no significant associations were observed with age, tumor differentiation, stage, or treatment modality. The median time to recurrence was 13.4 months, and 83.6% of patients with recurrence died during follow-up. DFS was markedly lower in patients with recurrence compared with those without recurrence (p<0.001). Recurrence independently predicted poor survival (HR 4.20, 95% CI 2.94–6.00). Discussion: Recurrence emerged as the strongest determinant of adverse survival, consistent with previous studies highlighting its profound impact on long-term outcomes (1–3). The higher recurrence rate observed among female patients suggests possible sex-related biological differences requiring further investigation (4). These findings reinforce the importance of vigilant surveillance and early recurrence detection (5). Conclusion: Recurrence is a critical prognostic factor in LARC and is associated with substantially reduced survival. Enhanced follow-up strategies and further research into sex-specific mechanisms may improve patient management and outcomes. |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| certificate-recurrence RC.pdf | 1404/10/07 | 130425 | دانلود |
| ICGH2025.the 20th maniscript.Recurrent rectal cancer.jpg | 1404/10/07 | 1924522 | دانلود |
