A Borda Martín, J M Martínez-Peñuela Virseda, M Muñoz Navas, C Prieto Martínez, M Betés Ibáñez, F Borda Celaya
{"title":"[Analysis of possible influence of synchronous neoplastic lesions on prognosis of resected colorectal cancer].","authors":"A Borda Martín, J M Martínez-Peñuela Virseda, M Muñoz Navas, C Prieto Martínez, M Betés Ibáñez, F Borda Celaya","doi":"10.4321/s0212-71992008000700002","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To analyze the relationship between synchronous lesions in patients with colorectal cancer and their prognostic value.</p><p><strong>Patients and methods: </strong>We have retrospectively reviewed 369 patients with resected colorectal cancer. We compared the rate of apparently curative surgery, progression and tumoral relapse, development of extracolonic cancer and mortality between patients with and without synchronous cancer. Afterwards, we analyzed the same parameters in colorectal cancer with and without synchronous adenomas. Finally, we repeated the analysis after stratification of cancers in 2 groups according to pTNM staging: 0-I-II stage vs III-IV.</p><p><strong>Results: </strong>We found synchronous adenomas in 54.7% of our patients and synchronous cancers in 7.6%. Follow-up period of groups with and without synchronous lesions were: 70.8 +/- 22.9 and 67.2 +/- 24.5 months (p = 0.55) respectively. Synchronous cancers showed higher mortality: 35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression : 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage, patients with stage 0-I-II and synchronous cancer showed worse prognosis: mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical differences between cases with and without synchronous adenomas.</p><p><strong>Conclusions: </strong>Synchronous cancers showed worse prognosis after resection, with higher rate of tumoral progression and mortality. This difference is focused on the cases diagnosed in stage 0-I-II, not being found in III-IV. The presence of synchronous adenomas doesn't influence prognosis.</p>","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales De Medicina Interna","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4321/s0212-71992008000700002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Aim: To analyze the relationship between synchronous lesions in patients with colorectal cancer and their prognostic value.
Patients and methods: We have retrospectively reviewed 369 patients with resected colorectal cancer. We compared the rate of apparently curative surgery, progression and tumoral relapse, development of extracolonic cancer and mortality between patients with and without synchronous cancer. Afterwards, we analyzed the same parameters in colorectal cancer with and without synchronous adenomas. Finally, we repeated the analysis after stratification of cancers in 2 groups according to pTNM staging: 0-I-II stage vs III-IV.
Results: We found synchronous adenomas in 54.7% of our patients and synchronous cancers in 7.6%. Follow-up period of groups with and without synchronous lesions were: 70.8 +/- 22.9 and 67.2 +/- 24.5 months (p = 0.55) respectively. Synchronous cancers showed higher mortality: 35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression : 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage, patients with stage 0-I-II and synchronous cancer showed worse prognosis: mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical differences between cases with and without synchronous adenomas.
Conclusions: Synchronous cancers showed worse prognosis after resection, with higher rate of tumoral progression and mortality. This difference is focused on the cases diagnosed in stage 0-I-II, not being found in III-IV. The presence of synchronous adenomas doesn't influence prognosis.
目的:分析结直肠癌患者同步病变与预后的关系。患者和方法:我们回顾性分析了369例结直肠癌切除术患者。我们比较了手术的明显治愈率、肿瘤的进展和复发、结外癌的发生以及伴有和不伴有同步癌的患者的死亡率。随后,我们分析了伴有和不伴有同步性腺瘤的结直肠癌的相同参数。最后,我们根据pTNM分期将肿瘤分层后重复分析,分为两组:0-I-II期和III-IV期。结果:54.7%的患者发现同步腺瘤,7.6%的患者发现同步癌。有无同步病灶组随访时间分别为:70.8 +/- 22.9个月和67.2 +/- 24.5个月(p = 0.55)。同步癌的死亡率更高:35.7% vs. 14.4%: p = 0.006;OR = 3.31(1.33-8.13),较高肿瘤进展:39.3 vs. 19.1%: p = 0.011;OR = 2.75(1.14-6.56),复发率较高:10.7 vs. 3.5%: p = 0.096。按分期分层,0-I-II期及同期癌患者预后较差:死亡率= 27.7 vs. 8.1%, p = 0.019;OR = 4.45(1.2 ~ 15.1),肿瘤进展= 27.8 vs. 8.5%, p = 0.02;OR = 4.12(1.14-14.19),结肠外癌= 16.7 vs. 6.4% p = 0.095。同时性腺瘤与非同时性腺瘤之间无统计学差异。结论:同步癌切除术后预后较差,肿瘤进展率和死亡率较高。这种差异主要集中在0-I-II期诊断的病例上,而在III-IV期没有发现。同时性腺瘤的存在不影响预后。