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Correlation of pathological factors with survival of patients submitted to coloretal resections due to adenocarcinoma

Gilmar Ferreira do Espírito Santo José Eduardo de Aguilar-Nascimento Marina Okuyama Kishima Arlei Takiuchi About the authors

BACKGROUND: The aim of this study was to evaluate the influence of the pathological aspects as prognostic for survival in patients who underwent resection for colorectal adenocarcinoma. METHOD: A historical cohort study was conducted based on an analysis of 119 patients with colorectal adenocarcinoma submitted to curative intention resection at the Department of Surgery of the Júlio Müller University Hospital from 1984 to 2002. Data were obtained from medical records. Specimen slides were reviewed and the findings were submitted to the survival analysis using the Kaplan-Meier method. The rectum was the location most frequent found (44,5%). The predominant macroscopic aspect was ulcerated or infiltrate type (50,4%), with lengths between 2 and 17 cm, and the majority of the tumors (64,7%) infiltrated until the serosa layer. The average number of lymph nodes examined in the surgical specimen was 11,8(±7,3) showing 42,8% of metastatic envolviment. Most of the tumors (85,4%) were categorized as either well or moderately differentiated. Angiolymphatic embolization and perineural invasion were observed in 51,2% and 23,5% respectively. RESULTS: There was no statistical significance of survival with morphology (p=0,87), length of the tumor (p=0,56) and degree of cellular differentiation (p=0,83). The factors that correlated with survival were location of the tumor (p=0,04), angiolymphatic embolization (p=0,02), perineural invasion (p <0,01), wall infiltration (p=0,02), and lymph node involvement (p <0.01). CONCLUSION: Survival of patients operated for colorectal adenocarcinoma showed significant correlation with site of the tumor, extension through gut layers, angiolymphatic embolization, perineural invasion, and lymphonodal involvement.

Colorectal neoplasms; Adenocarcinoma; Prognosis; Survival rate

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