The Clinical Study On The Lymph-node Metastasis Of The 186 Rectal Cancer Cases

the clinical and followed-up information of one hundred and eighty-six cases of rectal cancer was studied retrospectively who were treated in our department from Jan. 1995 to Dec.2002. All the cases were confirmed by operation and pathologic examination. The influential factors of lymph-node metastasis, the mutual influence between operation and lymph-node metastasis were analysed in this paper, what's more, this paper also studies the effect that the lymph-node metastasis had on the staging and prognosis of rectal cancer. Results: Univariate analysis indicates that the patients age, the tumor's location infiltration extent around bowel wall, gross morphology, growing way, histological type and differentiation and the infiltration depth were the influential factors on lymph-node metastasis, among these, the tumor's location, gross morphology, histological type and differentiation and the infiltration depth were the most important factors. 3.42 metastatic lymph nodes were checked each on the patients who were treated with conventional radical operation, whereas 4.35 metastatic lymph nodes on the patients with total mesorectal excision. The difference was significant between two groups. The 5-year survival of the patients without lymph-node metastasis is 76.81%, compared to 37.36% of patients with lymph-node metastasis. The patients with less than or no less than four metastatic lymph nodes, the 5-year survival of the patients is 45.14% and 23.12% respectively. There is significant statistic difference between two groups. Conclusions: Patients age, the tumor's location, infiltration extent around the bowelwall, growing way, gross morphology, histological type and differentiation and infiltration depth were influential factors of lymph-node metastasis. Among these, the tumor's location, gross morphology, histological type, differentiation and infiltration depth were the most important factors. The lymph-node metastasis of rectal cancer has no relations with patient's sex and the tumor's diameter. Total mesorectal exsicion was more radical than conventional operation from the point of clearing metastatic lymph node. Lymph-node metastasis is an important clinical proof which can tell the prognosis of the patients of rectal cancer. The number of the metastatic lymph-node can be used as the standard for the secondary clinical staging. According to this, different adjuvant therapy should be choosed.