Metastatic Lymphadenopathy in Colon Cancer

Abstract

METASTATIC LYMPHADENOPATHY IN COLON CANCER (Abstract): INTRODUCTION:The incidence and prevalence of colon cancer is increasing in the last decades, in Romania. The aim of this paper is to evaluate the place of metastatic lymphadenopathy as risk factor for postoperative morbidity and mortality. MATHERIAL AND METHODS: We perfomed a prospective study; 126 patients with colon cancer were included and prospectively reviwed. RESULTS: The men / women ratio was 70 / 56. The mean age was 65.26 years old (range 20-89 years). Most cases were in stage III (n=72, 57.14%) and IV (n=49, 38.89%) with tumors located more frequently on the left colon (n=86, 68.25%) and especially on the sigmoid colon (n=64, 50.79%). 33.33% patients (n=42) were operated in emergency. Colic wall invasion depth (pT 3 =49, 38.9%, pT 4 =72, 57.1%) were accompanied by an increase in the number of affected regional lymph nodes (pN 1 =29, 23.0%, pN 2 =43, 34.1%). Postoperative complications occurred only in patients in stages III (n=11, 15.41%) and IV (n=15, 30.61%). The 30 days postoperative mortality rate was 19.04% (n=24), mostly in stage pT 4 tumors (n=18, 25%). Metastatic adenopathy was found as risk factor for postoperative mortality rate: 16.66% (n=4) deaths for pN 1 , 30.23% (n=13) for pN 2 and resoectively 13.07% (n=7) mortality rate for pN 0 . The five years survival rate was 100% for stage I, 59.64% for stage II, 33.57% for stage III and nul for stage IV. CONCLUSIONS: The presence of metastatic adenopathy is crucial in assessing the informational value of early and late postoperative evolution.

Necessity to Review Atlanta Classification of Acute Pancreatitis

“…O mai bună înţelegere a fiziopatologiei pancreatitei acute [24][25][26], a insuficienţei multiple de organe [27][28][29], îmbunătăţirea diagnosticului imagistic [30][31][32][33], şi dezvoltarea mijloacelor miniinvazive radiologice [34], endoscopice [35], noile tehnici de tratament operator a complicaţiilor [36,37] au făcut necesară revizuirea Clasificării Atlanta [28,[38][39][40].…”