[Prognosis of rectal cancer patients after total mesorectal excision].

Background and objective: Total mesorectal excision (TME) can reduce local recurrence and improve prognosis of rectal cancer. This study was to analyze the clinicopathologic characteristics of rectal cancer, and explore the prognosis factors of rectal cancer after radical TME.

Methods: From 1990 to 2003, 1056 rectal cancer patients had received radical TME. The impacts of 20 clinicopathologic factors on the prognosis were analyzed with univariate and multivariate method.

Results: The 3-, 5-, and 10-year overall survival rates were 84.9% (95% CI, 83.8%-86.0%), 73.8% (95% CI, 72.4%-75.2%), and 65.1% (95% CI, 63.4%-66.8%), respectively. Univariate analysis showed that preoperative serum carcinoembryonic antigen (CEA) and CA19-9 levels, tumor gross type, pathologic type, pathologic grade, preoperative bowel obstruction or bowel perforation, T stage, N stage, and first treatment era were associated with the prognosis of rectal cancer. Multivariate analysis showed that N stage, histological type, surgical procedures, and T stage were independent prognostic factors.

Conclusion: N stage, histological type, surgical procedures, and T stage are independent prognostic factors for rectal cancer patients who received radical TME.