Laohavinij Sudsawat, Maneechavakajorn Jedzada, Techatanol Parapat
Oncology Unit, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2010 Oct;93(10):1156-66.
To determine the prognostic value for survival of pretreatment characteristics and treatments in stage 1-IV colorectal cancer (CRC) patients.
The present retrospective cohort study was conducted by reviewing 287files of stage I-IV CRC patients. Fifteen clinical variables were investigated through analysis as prognostic factors for survival.
The median survival time for CRC patients, colon and rectal cancer patients were 37.2, 43.2, and 29.5 months respectively The 5-year survival rates of CRC patients were 38.6%. 5-year stage-specific survivals for stage I, II, III and IV CRC were 100%, 68%, 44%, and 2% respectively (p < 0.001). Sixty eight percent of CRC patients were in stages III and IV Multivariate analysis revealed age > or =60 years old, WHO performance status 3, stage III and IV disease and poorly differentiated histology as poor prognostic factors for survival, whereas treatment with complete surgical resection and adjuvant chemotherapy was a good prognostic factor for survival in CRC.
As the majority of patients were in advanced stages with poor prognosis, early stage disease identification and treatment with newer agents would likely improve survival of high-risk CRC patients.
确定Ⅰ - Ⅳ期结直肠癌（CRC）患者治疗前特征及治疗方法对生存的预后价值。
本回顾性队列研究通过查阅287例Ⅰ - Ⅳ期CRC患者的病历进行。通过分析15个临床变量作为生存的预后因素。
CRC患者、结肠癌患者和直肠癌患者的中位生存时间分别为37.2个月、43.2个月和29.5个月。CRC患者的5年生存率为38.6%。Ⅰ、Ⅱ、Ⅲ、Ⅳ期CRC的5年阶段特异性生存率分别为100%、68%、44%和2%（p<0.001）。68%的CRC患者处于Ⅲ期和Ⅳ期。多变量分析显示年龄≥60岁、世界卫生组织（WHO）体能状态为3、疾病处于Ⅲ期和Ⅳ期以及组织学分化差是生存的不良预后因素，而完整手术切除及辅助化疗是CRC患者生存的良好预后因素。
由于大多数患者处于预后较差的晚期，早期疾病识别及采用更新的药物治疗可能会改善高危CRC患者的生存。
