RESUMO
AIM: The nodal harvest was studied to identify factors that affected the number of lymph nodes (LNs) retrieved in patients undergoing curative surgery for colorectal cancer. The influence of predictive factors on overall and disease-free 5-year survival was analysed. METHOD: All patients diagnosed with colorectal cancer who underwent oncological resection consecutively from January 1996 to December 2011 in a single institution have been studied. Factors influencing LN retrieval were analysed. A logistic regression analysis was performed to determine the factors that predicted a recovery of more than 12 LNs. A Cox regression analysis was made to identify the predictive factors of overall and disease-free 5-year survival. RESULTS: A total of 1166 patients were included in the study. The factors associated with the number of LNs harvested in surgical resections were age, colorectal surgeon, right colectomy, total colectomy, year of surgery, number of LN metastases and lymphocyte response. The factors that predicted a recovery of ≥ 12 LNs were age < 60 years, right colectomy, year of surgery and expert pathologist. A recovery of ≥ 12 LNs did not show significant differences in overall and disease-free 5-year survival, but the factor of colorectal surgeon did. CONCLUSION: Number of LN metastases, lymphocyte response, type of surgical resection, age of patient and colorectal surgeon can predict the LN harvest. Survival in colorectal cancer, however, is probably more influenced by the performance of the operation by an expert surgeon than by recovery of more than 12 LNs.
Assuntos
Adenocarcinoma/secundário , Colo/cirurgia , Neoplasias Colorretais/patologia , Excisão de Linfonodo , Adenocarcinoma/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Colectomia , Colo/patologia , Neoplasias Colorretais/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Padrões de Prática Médica , Modelos de Riscos ProporcionaisRESUMO
The authors study the 5 and 10 years survival of 1.058 cases of breast carcinoma treated between 1963 and 1981, classified according to the pTNM system. They suggest the convenience of eliminating some of the combinations in order to obtain a good correlation with prognostic criteria. The authors propose a modification of the TNM system with closer clinical significance.
