D'Eredita G, Serio G, Neri V, Polizzi R A, Barberio G, Losacco T
Cattedra di Semeiotica Chirurgica, Università di Bari, Italy.
Aust N Z J Surg. 1996 Jul;66(7):445-51. doi: 10.1111/j.1445-2197.1996.tb00780.x.
Many prognostic factors of colorectal cancer are known but their actual clinical validity is still uncertain. The aim of the present study was to verify, on the basis of our experience, the prognostic validy of variables for survival by using survival regression analysis.
From January 1978 to December 1986 the prognostic factors for 192 patients were analysed. These patients had undergone surgical resection for colorectal cancer. The follow up was completed in every patient by the end of December 1992, with a median follow up of 10 years (range 6-14 years). The prognostic factors considered in the statistical analysis were age, sex, size of tumour, site, grade, direct spread, node involvement and stage (according to Astler-Coller and pTNM).
Of the prognostic factors, sex was the only one not to show any prognostic significance. In the survival regression analysis we have used an accelerated failure time model (equivalent to the Cox proportional hazard model); age, grade and stage were significant covariables.
Although clinical pathological staging (pTNM) appears as a pre-eminent prognostic factor, and as our analysis shows, it needs a further variable (grading), which has been shown to affect the prognosis in a significant way.
许多结直肠癌的预后因素已为人所知，但其实际临床有效性仍不确定。本研究的目的是根据我们的经验，通过生存回归分析来验证生存变量的预后有效性。
分析了1978年1月至1986年12月期间192例患者的预后因素。这些患者均接受了结直肠癌手术切除。到1992年12月底，每位患者均完成随访，中位随访时间为10年（范围6 - 14年）。统计分析中考虑的预后因素包括年龄、性别、肿瘤大小、部位、分级、直接扩散、淋巴结受累情况及分期（根据阿斯特勒 - 科勒分期法和pTNM分期法）。
在这些预后因素中，性别是唯一无任何预后意义的因素。在生存回归分析中，我们使用了加速失效时间模型（等同于Cox比例风险模型）；年龄、分级和分期是显著的协变量。
尽管临床病理分期（pTNM）似乎是一个首要的预后因素，但正如我们的分析所示，它还需要另一个变量（分级），分级已被证明对预后有显著影响。
