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Revista Brasileira de Coloproctologia

On-line version ISSN 0101-9880

Abstract

MUSSNICH, Heloisa Guedes et al. Prognostic factors and survival in primary rectal adenocarcinoma. Rev bras. colo-proctol. [online]. 2008, vol.28, n.1, pp.62-71. ISSN 0101-9880.  http://dx.doi.org/10.1590/S0101-98802008000100009.

The objective of this study was to evaluate survival and clinicopathological factors in rectal adenocarcinoma, the records of 112 patients were reviewed for: age, gender, serum level of CEA, surgery curability, follow-up, recurrence, survival and tumor histopathology. Kaplan-Meyer curves were used to analyze survival. Statistical significance in bivariate and stratified analysis was set at P < 0.05. In the multivariate model, a 90% confidence interval was considered significant. Median follow-up was 35 (14 - 57) months. Five-year survival rate was 51%. Sixty-four patients (57%) had recurrence; 45 (40%) died from neoplasia, 68% tumors extended to perirectal tissues and 67 had positive lymph nodes (30% each, N1 and N2). Fourteen patients were Dukes D stage; 55 were C1 and C2; 15 were B2; and 28 were B1 and A. Death increased significantly with tumor progression stages (P<0.001), tumor depth (P=0.013) and grade (P=0.009), lymph node involvement (N2>N1, P<0.001) and recurrence (P<0.001). Independent prognostic factors were Dukes stages and tumor grade (P=0.089), as well as depth of invasion and lymph node involvement when Dukes staging was excluded (P=0.091 and <0.001). Besides tumor grade, the prognostic factors identified meet classification levels in current staging systems.

Keywords : Rectal adenocarcinoma; prognostic factors; histopathological staging; recurrence; survival.

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