Colorectal cancer is a major cause of mortality in the worldwide. Rectal cancer (RC) accounts for approximately 30% of all colorectal cancer cases. The aim of this study was to determine the survival rates and define prognostic factors in RC patients

In this retrospective cohort study, 181 cases of RC were recorded from March 21, 2006, to 2011, and follow-up to 2017(cutoff date). Data were analyzed using the Kaplan-Meier method and log-rank test for the univariate analysis of survival in various subgroups. All significant factors that influenced the survival of patients were further analyzed in a multivariate analysis using Cox' regression and a value of P < 0.05 was set as statistically significant.

Of the 181 patients analyzed, 114 (63%) were males. The mean age was 56.6±15.2, ranging from 15 to 88 years. The most common presenting was hematochezia (66.9%). The mean tumor distance from the anal verge was 8.4 (SD, 4.6; range, 1–20) cm and the mean hemoglobin was 12.3 ±1.9, (range, 6.6–15.8). 1 , 3, 5 and 10-year survival rates were 81%, 54% , 44 %and 33%, respectively and median survival time was 39.1 ± 9.2 (CI 95%=21.1-57.1) months. In the univariate analysis, place of residence (P=0/009), education (P=0/008), clinical presentation (P=0/001), rectal obstruction (P=0/006), Type of surgery (P=0/001), treatment strategy (P=0/001) and tumor stage (P=0/001) were significant prognostic factors. Sex, tumor distance from the anal verge, tumor differentiation did not show any significant effects on the survival rate. In multivariate analysis, tumor stage (P=0/001) and treatment strategy (P=0/001) were significant independent predictors of survival.

In summary, the prognosis of rectal cancer in the North West of Iran is poor. Therefore, treatment strategy and early detection should be emphasized to improve survival.