Prognostic Factors Affecting Recurrence and Disease-Free Survival after Surgical Resection of Cancer Rectum

Mubarak, Mohammed; Taha, Abdallah; Abozeid, Mahmoud A.; Safy, Ahmed Mohamed; Jaber, Murad; Omar, Mohammed A.; Saada, Ahmed

doi:10.21608/asjs.2025.362697.1186

Prognostic Factors Affecting Recurrence and Disease-Free Survival after Surgical Resection of Cancer Rectum

Document Type : Original Article

Authors

¹ Department of General Surgery, Faculty of Medicine, South Valley University, Qena, Egypt

² Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt

10.21608/asjs.2025.362697.1186

Abstract

Background: This retrospective study aimed to identify predictors of tumor recurrence and disease-free survival
in patients who underwent curative surgery for rectal cancer.
Patients and methods: Authors analyzed data of 229 patients with rectal cancer who underwent curative surgery.
Chi-square test and Binary logistic regression were used to identify factors predicting recurrence. Kaplan-Meier
product-limit method was used to identify the relations between co-variables for time of tumor recurrence.. Cox
Regression was used to multivariate analysis to detect the most significant factor predicting DFS.
Results: Factors predicting tumor recurrence were age, gender, lymphovascular invasion, the more advanced
tumor stage, distal resection margin lesser than 1 cm, non-effective neoadjuvant therapy, not receiving Adjuvant
therapy, greater Positive lymph node count, and greater lymph node ratio.
In Multivariate analysis, younger age, female gender, greater LNR were the main significant predictors of recurrence.
In Univariate analysis, factors significantly predicting Disease-free survival were Age, Histopathological Examination,
Distal Resection Margin in cm, PLNC, Lymph node ratio, Effectiveness of Neoadjuvant therapy, Receiving
Adjuvant therapy.
In Multivariate analysis, positive lymph node count and Adjuvant therapy were the main significant predictors of
DFS.
Conclusion: Multivariate analysis identified younger age, female gender, and lymph node ratio (LNR) as the
main significant predictors of recurrence. PLNC and Adjuvant therapy were the main significant predictors of DFS.
Integrating identified predictors of rectal cancer recurrence and DFS into clinical practice might improve personalized
management strategies and long-term outcomes. Identifying those factors might affect adjuvant-therapy
decision-making and patient follow up planning.

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