Five Year Survival Analysis Of Colorectal Adenocarcinoma

Objective:Explore the impact of vascular and neural invasion on the prognosis of colorectal adenocarcinoma patients,and group discussion on the risk factors of their impact on prognosis.Methods:From January 1,2012 to December 31,2018,the patients with colorectal adenocarcinoma who visited the emergency surgery and general surgery of The First Affiliated Hospital of Nanchang University and underwent "radical resection of colorectal cancer" were selected,of which 308 patients met the inclusion and exclusion criteria,and 283 patients were followed up.According to the situation of vascular and nerve invasion,patients were divided into four groups in this study,namely:(1)patients without vascular and nerve invasion(V0N0);(2)Patients without vascular infiltration but with nerve invasion(V0N1);(3)Patients with vascular infiltration but no nerve invasion(V1N0);(4)Patients with vascular and neurological invasion(V1N1).Firstly,calculate the one-year,three-year,and five-year survival rates of these four groups of patients.Subsequently,Kaplan Meier analysis was used to calculate and plot survival curves for various factors and evaluate prognostic factors.Next,logistic regression analysis was used to conduct single factor and multivariate analyses to determine the risk factors that contribute to the V1N1 group.Results:(1)The one-year,three-year,and five-year survival rates of the V0N0 group were better than those of the other three groups,and there was a significant difference in survival rates between subgroups(P<0.001).For colorectal adenocarcinoma patients with negative and positive regional lymph node metastasis,Stage I-II,and Stage III-IV,there were differences in overall survival rates among the V0N0,V0N1,V1N0,and V1N1 groups(P<0.001).However,for the tumor infiltration depth T1-2,there was no statistically significant difference in overall survival rate between groups(P>0.05).(2)Using univariate logistic regression analysis,the results showed that lymph node metastasis,tumor gross type,chemotherapy,and tumor staging were risk factors for simultaneous vascular and nerve invasion,with statistical significance(P<0.05).(3)For patients in the V1N1 group,postoperative adjuvant chemotherapy can prolong the overall survival rate of patients with statistical differences(P<0.001),while for the other three groups,the impact of postoperative adjuvant chemotherapy on overall survival rate was not statistically significant(P>0.05).Conclusion:Colorectal adenocarcinoma patients(V1N1)with both vascular and neural invasion exhibit poorer overall survival compared to patients with only vascular or neural invasion(V1N0 or V0N1)or patients without vascular or neural invasion(V0N0).Lymph node metastasis,general type of tumor,chemotherapy,and clinical stage of the tumor are risk factors for concurrent vascular nerve invasion in colorectal adenocarcinoma patients.In addition,adjuvant chemotherapy may prolong the overall survival rate of colorectal adenocarcinoma patients with simultaneous vascular and nerve invasion.Vascular infiltration and nerve invasion are important prognostic factors for colorectal adenocarcinoma patients.