Survival Analysis Of Different Lymph Node Status In Patients With T3,T4 Colorectal Cancer Treated By Radiotherapy

Object: Retrospective analysis of radiotherapy survival analysis of T3-4N0-2M0 rectal cancer patients.Methods: The data of patients undergoing radical resection of rectal cancer from January 2010 to December 2011 in our hospital with pT3-4N0-2M0 were collected.SAS 9.2 statistical software was used to analyze overall survival(OS)and progression-free survival(PFS).Results:In this study,443 patients were enrolled and 70 patients(15.80%)received radiotherapy.In OS,the HR value of radiotherapy group was 1.095(P=0.923)compared with non-radiotherapy group.There was no significant difference in overall survival between the two groups.In terms of PFS,the radiotherapy group compared 1.801 for the untreated group(P=0.003).It is suggested that the patients in the radiotherapy group have shorter local prominence than those in the non-radiotherapy group,and they are concerned with patient selectivity.According to lymph node status and radiotherapy,the patients were divided into four groups: lymph node negative radiotherapy group RT(LN-),lymph node positive radiotherapy group RT(LN+),lymph node negative non-radiotherapy group Non-RT(LN-),lymph node positive non Radiotherapy group Non-RT(LN+).Analysis of OS was performed in each group compared with Non-RT(LN-)group,RT(LN-)group was compared with Non-RT(LN-)group,RT(LN+)group was compared with Non-RT(LN-)group,The HR values of Non-RT(LN+)group compared with Non-RT(LN-)single factor and multivariate analysis were 1.516(P=0.252)and 1.509(P=0.312),2.171(P=0.004)and 2.033(P= 0.027),2.897(P<0.001)and 2.875(P<0.001).Analysis of PFS,RT(LN-)group vs.Non-RT(LN-)group,RT(LN+)group vs.Non-RT(LN-)group,Non-RT(LN+)group vs.Non-RT(LN-)the HR values ? ? of group single factor and multivariate analysis were 1.696(P=0.252)and 2.083(P=0.035),3.171(P<0.001),and3.045(P<0.001),2.641(P<0.001),and 2.435(P <0.001).Multivariate analysis showed that the failure rate was higher in the RT(LN-)group than in the Non-RT(LN-)group and was considered to be related to population selection;the failure rate of LN+ patients was higher than that of the LN-group.For further stratified analysis,in the LN-group of patients with OS,the HR of the radiotherapy group compared with the non-radiotherapy group was2.228(P=0.062);the HR of the LN+ group of patients with the non-radiotherapy group was 0.622(P=0.147).Although there was no statistically significant difference,the HR value in the LN+ group was <1,suggesting that in the LN+ group,radiotherapy has a good prognosis.Similarly,in the LN+ group,the HR was also decreasing in PFS.Overall,radiotherapy has a good prognosis for lymph node positive patients.Conclusions:1.Radiotherapy did not improve overall survival in patients with T3-4N0-2M0 rectal cancer.2.Lymph node positive patients with T3,T4 colorectal cancer have lower overall survival and progression-free survival.3.Radiotherapy has a good prognosis for patients with positive lymph nodes of T3,T4 colorectal cancer.