RESUMO
Synchronous carcinomas of the colon and rectum are of considerable clinical significance because of their frequency, the number of extra tumours missed and the difficulty of preoperative diagnosis. A retrospective evaluation of 283 patients with primary colorectal adenocarcinomas was performed. There were 6 patients with 12 synchronous adenocarcinomas (2.12%). Colonoscopy and double-contrast barium enema revealed the synchronous cancer in 66.6% of the cases. In two cases the second cancer was found intraoperatively. In one patient an urgent laparotomy was performed because of acute abdomen caused by perforation of the ascending colon. Typical colectomies, depending upon the segment of the location of the lesion, were performed. Second cancers had a significantly more favourable stage than index colorectal adenocarcinomas. The index and the secondary cancers of synchronous colorectal adenocarcinomas showed a better histologic grade (well differentiated type) than the single cancers. Full clinical and radiological investigation is essential, before any operation is undertaken for colorectal cancer.
Assuntos
Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Neoplasias Primárias Múltiplas/epidemiologia , Adenocarcinoma/cirurgia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Colonoscopia/métodos , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/terapia , Cuidados Pré-Operatórios/métodos , Prevalência , Prognóstico , Estudos Retrospectivos , Distribuição por Sexo , Análise de SobrevidaRESUMO
The aim of our study is to present our initial experience on the use of radiofrequency ablation (RFA) on hepatic tumours. Four patients with tumours of the liver were submitted to RFA. The first patient underwent an emergency left lobectomy due to rupture of a tumour of the left hepatic lobe. A synchronous tumour was detected on the right lobe. He has been submitted to four sessions of RFA. The second patient was submitted to transverse colon resection (adenocarcinoma) and a year later three metastatic tumours were detected. Two sessions of RFA have been applied in this case. The third patient, with adenocarcinoma of the sigmoid and one metastatic lesion on the right hepatic lobe, and the fourth patient with breast cancer and metastatic lesion of the liver, underwent one session of RFA each. The use of RFA on metastatic or primary tumours of the liver enriches the possibilities of therapeutic treatment.
Assuntos
Ablação por Cateter/métodos , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Idoso , Ablação por Cateter/efeitos adversos , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Intervalo Livre de Doença , Feminino , Seguimentos , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estadiamento de Neoplasias , Medição de Risco , Estudos de Amostragem , Resultado do TratamentoRESUMO
It is acceptable that the stage of disease at time of attendance of patients with colorectal cancer (CRC) is the defining factor for patients' survival rate. From 1986 until 1998, 417 patients were treated in the Department of Surgery of the General Hospital of Edessa with CRC. For diagnosis, established endoscopic procedures were followed. CT, USG, MRI and histology were performed for staging. 85.4% of the patients had stage II, III and IV TNM/UICC tumour at the time of attendance.
