Histopathological factors as predictors for survival in colon and rectal cancers.

Colorectal cancer is one of the most frequent malignant diseases with a raising incidence in Romania. Survival at 5-years even was improved in the last decade, remains low especially because of delayed diagnosis. Many clinical-biological and pathological factors have demonstrate a good prognostic value over the time but there are not a wide consensus in this field. The aim of our study is to evaluate the accepted pathological prognostic factors of survival for colorectal cancer in relation to management adopted in a general surgical clinic. We included in our study 273 patients with colon and rectal cancers admitted in Surgical Clinic of Military Hospital of Craiova in which we evaluate the clinical-pathological features, location of the distant metastasis, postoperative staging, curability and survival. We established correlations, inside of a same stage of the disease, for pathological features (characters of the tumors, differentiation grade and location) and survival rate. Our results showed that curative resection is one of the most important factors that could improve survival. Tumor differentiation is correlated with survival only for the patients with stage II and III of the disease, perineural invasion and pathologic N stage representing important predicting factors for a shorter survival. Peritoneal washing for cytology prior to surgery is correlated with the stage of the disease and not with tumor differentiation.

Giant retroperitoneal sarcomas.

Retroperitoneal sarcomas are rare malignant tumors, which are developing from mesenchymal stem cells residing in muscle, fat, and connective tissues. Underlying the rarity of this kind of tumors in general population, the aim of this paper is to present three cases of retroperitoneal sarcomas operated in Surgical Department of Military Hospital of Craiova (a retroperitoneal liposarcoma, a dedifferentiated liposarcoma and a malignant fibrous histiocytoma). From clinical point of view, we note the poverty of symptoms and non-specificity of these and a great tolerability of retroperitoneal space that offers the possibility for a great development of the tumor. CT-scan and MRI are the best investigations for diagnosis but surgical exploration is the best way for a good evaluation of these tumors. From histological point of view, we try to present new features about these kinds of tumors in order to classify them. Results of surgery correlated with complementary therapies were good without per-operative mortality or postoperative morbidity but we noted a recidive of one tumor (with different histological pattern) 21 months after the surgical intervention. The rarity of retroperitoneal sarcomas, combined with the vast array of histologic subtypes, has complicated our understanding of these tumors and impeded the development of effective therapies.