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[Prognostic factors in colorectal neoplasm. Multivariate analysis in 224 patients]
G Bannura1, M A Cumsille, J Contreras
1Servicio y Departamento de Cirugía, Hospital Clínico San Borja Arriarán, Campus Centro, Facultad de Medicina y Escuela de Salud Pública, Universidad de Chile. ghannura@rdc.cl
Background:
Staging of colorectal carcinoma has prognostic value and allows to take decisions about adjuvant therapy and follow up. Prognostic factors are not universally accepted and there are different staging classifications.
Aim:
To assess the prognostic value of clinical and pathological variables in 224 patients subjected to a curative resection of a colorectal carcinoma.
Patients And Methods:
A retrospective analysis of 99 men and 125 women, aged 23 to 91 years old subjected to a curative resection of a colorectal carcinoma and followed up for a mean of 72 months.
Results:
Global survival at 60 months was 72%. Univariate analysis showed that tumor localization, vascular permeation, wall infiltration and number of involved lymph nodes had an influence on survival. A Cox regression model disclosed tumor localization (colon versus rectum), a carcino-embryonic antigen over 30 ng/ml, vascular permeation, presence of 1 to 4 involved lymph nodes, or 5 or more lymph nodes and the presence of an apical lymph node as variables with significant prognostic value.
Conclusions:
Our series confirms the prognostic importance of lymph node involvement. This parameter is incorporated in Jass, GITSG (both modifications of Dukes classIfication) and TNM staging scores.