Total de linfonodos identificados após a ressecção do câncer colorretal

Abstract

-Background -The main base in surgical treatment of colorectal cancer is en-bloc removal of the tumor with adequate proximal and distal margins, combined with the removal of lymph nodes. Aim -To evaluate factors associated with the number of lymph nodes found in surgical specimens from patients with colorectal cancer. Methods -Analysis of a retrospective data of consecutive patients operated with a diagnosis of colorectal adenocarcinoma. Were excluded those undergoing palliative surgery. Demographic data, operative and histopathological findings were analyzed using the Fisher exact test, chi-square, Wilcoxon rank-sum and a logistic regression model. Results -From 2000 to 2008, were operated 298 patients with colorectal cancer. The data included in the analysis were available for 173 patients. Of these, 85 (49%) were female and median age was 65 (26-94) years. The resection was the most common left colectomy (45%), followed by right colectomy (23%). The median number of lymph nodes were isolated from eight (0-67) and 33% of patients had 12 or more lymph nodes identified in surgical specimens. Patients younger than 50 years and those who underwent right colectomy had a greater number of lymph nodes isolated. Conclusions -Patient age less than 50 years and the type of surgical resection are associated with higher number of lymph nodes found in surgical specimens. ABCDDV/772RESUMO -Racional -A base cirúrgica principal no tratamento do câncer colorretal é a remoção em bloco do tumor com adequadas margens proximal e distal, associada à remoção dos linfonodos mesentéricos.

Colorectal cancer in patients under age 50: a five-year experience

“…propose that the location in the rectum renders higher mortality from the disease 27,28 , others have failed to demonstrate any difference attributable to tumor location 26,29,30 . prognostic factors for overall survival, and T4 status, an independent factor for disease-free survival 33,34 .…”

“…The analysis of the number of lymph nodes isolated in the surgical specimen is essential for CRC staging, as it assists in the assessment of the disease extent and in the choice of adjuvant therapy, contributing proportionally to the increase in patients' overall survival. Colorectal cancer in patients under age 50: a five-year experience more advanced disease, and histopathological indicators showing a greater aggressiveness, which may have contributed to the broader surgical resection on the part of the surgeon, and as a consequence, a greater number of identified lymph nodes34 .Although patients in the group under 50 years of age had more advanced staging, the overall mortality rate was similar between the two groups. There was also no significant difference regarding recurrence.…”

Prognostic Factors for Left Colectomy for Colon Cancer: A Ten Years Experience of a Single University Institution

“…The need of a sufficient lymph node yield, adequate margins, and standardized operative techniques have been established, and was described in the present study 20 . The median number of regional lymph nodes harvested was 23 in this study, according to the literature, which may vary between 14 and 32 lymph nodes 4 , 22 . As the extent of lymph node dissection can be considered as an indicator of surgical and pathological quality these findings are supported by other studies demonstrating that the use of a standardized anatomy based upon dissection, and surgical technique was an independent factor influencing cancer specific survival and overall survival in affected patients 10 .…”

“…The majority of patients in the current study who underwent surgery had an adequate nodal assessment. The average of positive lymph nodes in the literature varies from 27 to 36% of the patients in the different series 4 , 8 , 21 . The results of the present study show lymph node involvement in a higher percentage of patients (41.6%), which was directly associated with worse survival rates.…”