关键词: 新辅助放化疗, 局部进展期直肠癌, 远期疗效, 预后因素

Abstract: Objective To further evaluate the long-term survival benefits and prognostic analysis of locally advanced rectal cancer patients after neoadjuvant chemoradiotherapy.
Methods Clinical characteristics of locally advanced rectal cancer patients were retrospectively collected from January,2013 to January,2016 in the Department of General Surgery of Beijing Chaoyang Hospital.Kaplan-Meier for survival curve and log-rank test for univariate prognostic analysis,Cox proportional hazard model was used for multivariate analysis.
Results A total of 97 rectal cancer patients were included.All patients received nCRT and TME.The median follow-up time was 39(6~83) months.The cumulative 5-OS and DFS were 77.4% and 74.1% respectively.Univariate prognostic analysis revealed that advanced ypTNM stage(χ2=11.282，P=0.01),ypN+(χ2=8.134，P=0.004) and non-pCR(χ2=4.550,P=0.033) patients had a worse OS,while ypN+(χ2=5.007，P=0.025) and lymphvascular invasion(χ2=3.330,P=0.048) were significantly associated with decreased DFS.Multivariate analysis showed that ypN stage was independent risk factor for both OS(HR=3.006,95%CI:1.220~7.407,P=0.017)and DFS(HR=2.998,95%CI:1.138~7.894,P=0.026).
Conclusion ypN+ was independent risk factor for both OS and DSF for locally advanced rectal cancer who received neoadjuvant chemoradiotherapy,and consolidation therapy after nCRT might be benefical for patients with high risk factors.

Key words: neoadjuvant chemoradiotherapy, locally advanced rectal cancer, long-term survival benefits, prognostic analysis