Multidimensional analysis of rectal cancer: Survival analysis and its trend with multiple variables - Single institutional ambispective study II.

Introduction: Rectal cancer is a significant health problem. The study was conducted to analyze the overall survival (OS) and disease-free survival (DFS) and their relation to multiple patient-related clinicodemographic factors.

Materials and methods: This ambispective study was conducted at a tertiary care referral and university teaching hospital. The data from the patient records were collected for the year 2014-2016 and followed till June 2021. OS and DFS and their relation with multiple clinicodemographic factors like smoking habits, marital status, stage of the disease, circumferential resection margin (CRM), and the treatment received were assessed.

Results: The overall 5-year mean DFS and OS for all stages were 59.13 and 56.81 months, respectively. The mean DFS and OS were significantly better for stage I disease at 83.96 and 84.16 months and least for stage IV at 27.72 and 32.61 months, respectively, (P = 0.001). The mean 5-year DFS and OS in patients undergoing upfront surgery were significantly higher at 59.93 and 62.70 months compared with patients who received other treatment options at 51.11 and 49.85 months (P = 0.002 and P = 0.001), respectively. The association of CRM and 5-year DFS was statistically significant (P = 0.001) with improved survival in CRM-negative at 62.91 months compared with 43.68 months in CRM-positive patients. Similarly, there was a significant 5-year OS benefit in CRM-negative patients (P = 0.001). The 5-year DFS and OS were statistically significant (P = 0.028 and P = 0.053) among married patients, respectively.

Conclusions: The study revealed the impact of stage, CRM, upfront surgery as well as marital status on the OS and DFS. This study reveals that survival patterns can be improved if cancer is detected early and receive proper treatment at proper time.