Elias D, Henry-Amar M, Lasser P, Gareer W, Bognel C
Gastroenterol Clin Biol. 1985 Nov;9(11):776-81.
Local recurrences (LR) after curative surgery have been analyzed in series of 173 rectal adenocarcinomas treated between 1973 and 1983. LR predictive factors were analyzed by univariate and multivariate (Cox model) studies. Five factors had no predictive value on LR: age, sex, tumor differentiation, tumor size, and number of metastatic nodes. Five factors had a predictive value on LR: severe clinical symptoms (fixation, obstruction and perforation) (p = 0.03), tumors localized within five cm of the anal verge (p less than 0.001), intramural infiltration (p = 0.09), localization of positive nodes (p = 0.02), and tumor emboli inside the vessels (p less than 0.01). The multivariate study underlined the two main predictive factors: the tumor site within 5 cm of the anal verge (p less than 0.001) and involvement of the serosa (p = 0.05). An equation of LR risk is presented and four subgroups of different LR risk patients are defined. This study might provide guidelines for indications and evaluation of major adjuvant treatments in the highest LR risk patients.
对1973年至1983年间接受治疗的173例直肠腺癌进行了根治性手术后局部复发（LR）情况的分析。通过单因素和多因素（Cox模型）研究分析了LR的预测因素。五个因素对LR无预测价值：年龄、性别、肿瘤分化程度、肿瘤大小和转移淋巴结数量。五个因素对LR有预测价值：严重临床症状（固定、梗阻和穿孔）（p = 0.03）、肿瘤位于距肛缘5厘米以内（p < 0.001）、壁内浸润（p = 0.09）、阳性淋巴结的位置（p = 0.02）以及血管内肿瘤栓子（p < 0.01）。多因素研究强调了两个主要预测因素：肿瘤位于距肛缘5厘米以内（p < 0.001）和浆膜受累（p = 0.05）。给出了LR风险方程并定义了四组不同LR风险的患者。本研究可能为LR高风险患者主要辅助治疗的适应证和评估提供指导。
