W Chen

University of Michigan, Ann Arbor, Michigan, United States

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Publications (2)4.16 Total impact

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    ABSTRACT: We studied the outcome and prognostic factors for T1 rectal cancer patients undergoing standard resection or transanal excision. One hundred and twenty-four patients with T1 rectal cancer were included in the study, of whom 66 (53.2%) underwent standard resection and 58 (46.8%) underwent transanal excision. Survival analysis was performed to compare the outcome. The 5-year local recurrence rate was 11.0% in the transanal excision group versus 1.6% in the standard resection group (P = 0.031) but the 5-year disease-free survival and overall survival rates were not significantly different between the two groups. Multivariate analysis suggested that a high tumour grade and perineural or lymphovascular invasion were independent risk factors for local recurrence and recurrence-free survival. For high-risk patients (with at least one of the above risk factors), the 5-year local recurrence and 10-year recurrence-free survival rates were 21.2% and 74.5%, versus 1.2% and 92.0% in low-risk patients (P = 0.00003 and P = 0.003). In patients undergoing transanal excision, none in the low-risk group had local recurrence during follow up, while 40% (6 of 15) of patients in the high-risk group developed local recurrence within 5 years after surgery. The 5-year local recurrence rate was 45.0%. Transanal excision in T1 rectal cancer may result in a high rate of local failure for patients with a high-grade tumour, or perineural or lymphovascular invasion. Local excision should be avoided as a curative treatment in high-risk patients.
    Colorectal Disease 02/2011; 13(2):e14-9. · 2.08 Impact Factor
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    M Wang, J Peng, W Yang, W Chen, S Mo, S Cai
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    ABSTRACT: Rectal carcinoid is a rare rectal tumour with a good prognosis. The aim of this study was to assess its clinicopathological characteristics and prognostic factors in a single institution. Clinical and pathological information was retrospectively collected in a single institution, and patients' outcomes were determined. Multivariate analyses were performed to find independent prognostic factors attributed to overall survival. A total of 106 patients with rectal carcinoid were included. In all, 66% of the patients underwent transanal local excision and 34% had transabdominal surgery. The 5-year survival rate was 87%. Muscularis invasion was the only independent prognostic factor for predicting 5-year survival (P = 0.00046). Tumour size was found to be significantly associated with muscular invasion (P = 0.00003). The area under the curve of tumour size in the receiver operating characteristic curve for predicting muscular invasion was 0.92. Patients with rectal carcinoid have a good prognosis. Muscular invasion is an independent risk factor of survival.
    Colorectal Disease 10/2009; 13(2):150-3. · 2.08 Impact Factor

Publication Stats

11 Citations
4.16 Total Impact Points

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Institutions

  • 2009–2011
    • University of Michigan
      • Department of Biostatistics
      Ann Arbor, Michigan, United States