Survival Time and Recurrent Rate in Patients with Rectum Cancer

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: One of the most prevalent intestinal cancers is rectum cancer causing 10% of mortality rate due to cancer. According to relative high prevalence of rectum cancer in Isfahan, Iran, the aim of this study was determining survival time and recurrent rate of this cancer in this region.Methods: This cross-sectional study for survival analysis was done in Alzahra hospital (Isfahan, Iran) during 2012-2013. 101 hospitalized consecutive patients with rectum cancer were selected. The necessary data such as demographic information, pathologic results and etc. were achieved from patients' records. We contacted patients' families for achieving completing data. All patients were followed for prognosis, death and recurrent after the surgery.Findings: The mean of survival time in all patients was 5.45 ± 0.45 years. According to Kaplan-Meier analysis, the median survival was 6.0 ± 0.9 years. Mean and median survival was statistically different based on the disease stage (P < 0.001); but other factors had not positive effect on patients' survival. The mean and median of relapse were 14.05 ± 2.30 and 12.00 ± 0.83 months, respectively. Chem-radiotherapy before the surgery statistically affected relapse time but other factors were not effective.Conclusion: Because of the high relapse and low survival rate in our patients in comparison with world statistics, protocols of treatment for rectum cancer must be revised. 

Keywords

References

  1. Gilsing AM, Franssen F, de Kok TM, Goldbohm RA, Schouten LJ, de Bruine AP, et al. Dietary heme iron and the risk of colorectal cancer with specific mutations in KRAS and APC. Carcinogenesis 2013. [Epub ahead of print]
  2. Becker N. Epidemiology of colorectal cancer. Radiologe 2003; 43(2): 98-104.
  3. Capdevila J, Saura C, Macarulla T, Casado E, Ramos FJ, Tabernero J. Monoclonal antibodies in the treatment of advanced colorectal cancer. Eur J Surg Oncol 2007; 33 (Suppl 2): S24-S34.
  4. Potter V, Conn A. Chemotherapy and radiotherapy in the treatment of colorectal cancer. Surgery 2006; 24(4): 137-40.
  5. Omidvari S, Hamedi SH, Mohammadianpanah M, Razzaghi S, Mosalaei A, Ahmadloo N, et al. Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer. J Egypt Natl Canc Inst 2013; 25(3): 151-60.
  6. Vasilescu C. Current problems in surgical oncology. Part 3. Total mesorectal excision with curative intent. Why are not all patients with rectal cancer treated with minimally invasive procedures (either by laparoscopy or by robotic surgery)?. Chirurgia (Bucur ) 2011; 106(3): 297-9.
  7. Fridman WH. Principles of the therapeutic use of monoclonal antibodies in oncology. C R Biol 2006; 329(4): 255-9.
  8. Harris M. Monoclonal antibodies as therapeutic agents for cancer. Lancet Oncol 2004; 5(5): 292-302.
  9. Way LW. Current surgical diagnosis and treatment. 11th ed. New York, NY: Appleton & Lange: 1997. P. 721-54.
  10. Nivatvongs S. Surgical management of early colorectal cancer. World J Surg 2000; 24(9): 1052-5.
  11. Sabiston DC, Lyerly HK. Text book of surgery. 16th ed. Philadelphia, PA: Saunders; 2001. p. 961-9.
  12. Yuan HY, Li Y, Yang GL, Bei DJ, Wang K. Study on the causes of local recurrence of rectal cancer after curative resection:analysis of 213 cases. World J Gastroenterol 1998; 4(6): 527-9.
  13. Boostrom SY, Dozois EJ. Recurrent pelvic surgery. Surg Clin North Am 2013; 93(1): 199-215.
  14. Bouchard P, Efron J. Management of recurrent rectal cancer. Ann Surg Oncol 2010; 17(5): 1343-56.
  15. Moynihan G.The surgical treatment of cancer of the sigmoid flexure and rectum. Surg Gynecol Obstet 1908; 6: 463-6.
  16. Kapiteijn E, van de Velde CJ. The role of total mesorectal excision in the management of rectal cancer. Surg Clin North Am 2002; 82(5): 995-1007.
  17. Harnsberger JR, Vernava VM, III, Longo WE. Radical abdominopelvic lymphadenectomy: historic perspective and current role in the surgical management of rectal cancer. Dis Colon Rectum 1994; 37(1): 73-87.
  18. Kapiteijn E, Marijnen CA, Colenbrander AC, Klein KE, Steup WH, van Krieken JH, et al. Local recurrence in patients with rectal cancer diagnosed between 1988 and 1992: a population-based study in the west Netherlands. Eur J Surg Oncol 1998; 24(6): 528-35.
  19. Edge SB, Byrd DR, Compton CC, Fritz AG, Trotti A. AJCC Cancer Staging Manual. 7th ed ed. New York, NY; 2010.
  20. Ostenfeld EB, Erichsen R, Iversen LH, Gandrup P, Norgaard M, Jacobsen J. Survival of patients with colon and rectal cancer in central and northern Denmark, 1998-2009. Clin Epidemiol 2011; 3(Suppl 1): 27-34.
  21. Yu CS, Yun HR, Shin EJ, Lee KY, Kim NK, Lim SB, et al. Local excision after neoadjuvant chemoradiation therapy in advanced rectal cancer: a national multicenter analysis. Am J Surg 2013; 206(4): 482-7.
  22. Tural D, Ozturk M, Selcukbiricik F, Yildiz O, Elicin O, Turna H, et al. Preoperative chemoradiotherapy improves local recurrence free survival in locally advanced rectal cancer. J BUON 2013; 18(2): 385-90.
  23. Mohiuddin M, Paulus R, Mitchell E, Hanna N, Yuen A, Nichols R, et al. Neoadjuvant chemoradiation for distal rectal cancer: 5-year updated results of a randomized phase 2 study of neoadjuvant combined modality chemoradiation for distal rectal cancer. Int J Radiat Oncol Biol Phys 2013; 86(3): 523-8.
  24. Ptok H, Mundt A, Lippert H, Gastinger I. Rectal Cancer Surgery in Germany - a 10-Year-Analysis Based on the Data of the "Institute of Quality Assurance in Operative Medicine" at the Otto-von-Guericke University Magdeburg. Zentralbl Chir 2013; 138(4): 418-26.
Journal of Isfahan Medical School
Volume 31, Issue 247 - Serial Number 247
July and August 2013
Pages 1194-1207

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History

  • Receive Date: 18 September 2013
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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