Evaluation of prognostic factors for 5 year-survival after surgery for colorectal cancer


COD: 2020_01_07_2967 Categorie: ,

Bogdan V. Micu, Ştefan C. Vesa, Tudor-Radu Pop, Carmen M. Micu

Ann. Ital. Chir., 2020 91, 1: 41-48

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AIM: The aim of this study was to assess and analyze the prognostic factors for survival in patients undergoing curative
surgery for colorectal cancer and to identify new prognostic factors.
METHODS: The prospective study included 301 patients diagnosed with colorectal cancer, stages I-III, undergoing curative
surgery. Demographic data, clinical and anamnestic data, laboratory exams, paraclinical examinations, morphological
and pathological examination were recorded. The Petersen index was calculated. Tumor necrosis, desmoplasia and
mucinous component were assessed. Local inflammatory response was calculated using Klintrup criteria. Patients were followed
for five years after surgery.
RESULTS: There were 197 patients (66.4%) who survived and 104 patients (34.6%) who died during the 5-year follow-
up period. Multivariate analysis showed that death was mostly associated with patients over 60 years of age (p=0.05).
Tumor location within the colon was associated with a better survival than tumor location within the rectum (HR –
0.57; p=0.02). Patients with T>2 had a poor prognosis compared to those with T=<2 (HR – 2.23; p=0.02). Patients with Klintrup score >1 had a better prognosis (HR – 0.20; p <0.001). Patients with venous invasion showed significantly worse prognosis (HR – 2.26; p=0.003). Patients with desmoplasia score 3 had lower death rates than those with score 1 (HR – 0.42; p=0.01). CONCLUSION: Survival was superior in patients with cancer of the colon. The following parameters had a strong independent prognostic factor for survival: age, stage T>2, venous invasion, mucinous component and desmoplasia.