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CLINICAL-MORPHOLOGICAL CORRELATIONS IN ADVANCED COLORECTAL CANCER

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Author(s): F.A. Dumitrescu | Gh. Bălan

Journal: Jurnalul de Chirurgie
ISSN 1584-9341

Volume: 7;
Issue: 4;
Start page: 622;
Date: 2011;
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Keywords: CANCER | COLORECTAL CANCER

ABSTRACT
Background: During 2000-2007 we have selected and supervised a lot of 279 cases operated for colorectal cancer in Clinic no.1 Surgery from “St. Spiridon” Hospital. The sex repartition during the entire study period shows the preponderance of male cases (61.29%) in comparison to the female cases of 38.7 %. In our study the operated colorectal carcinomas have a higher incidence at patients over 60 years old, 71.67%. There is as well a higher percent for the age group 60-70 years old and 70-80 years old which percent reaches 34.76% respectively 32.97% out of the total number of cases. When comparing the average age of the two analyzed lots there we can notice that the average age of the female patients does not differ significantly from the age of the male patients. The average age of the female patients was of 64,3±8,58 with minimum values of 51 years and maximum of 78 years and the average age of male patients was of 67,9±10,5 with minim of 44 years and maximum of 86 years. The on segments distribution of the colorectal cancer is presented as follows: rectum 108 cases (38,7%), sigmoid 96 cases (34,40%), descendent 19 cases (6,81%), hepatic angle 17 cases (6.09%), transverse 17 cases (6.09%), ascending 12 cases (4,3%) % the rest of the localizations being in a smaller number. In the case of males the colorectal cancer is met most often at the level of the rectum (32.74%) and the case of females at the level of the sigmoid (41.66%). Regarding the microscopic results they were: well differentiated adenocarcinoma 45.83%, moderate differentiated 43.75% and weak differentiated 10.42%. The Chi-square analysis shows that there is no association between the macroscopic aspects of the tumours and their histological aspect. Analyzing the microscopic aspect according to the location of the tumour there is observed that 86.95% of the tumours that were located at the level of the rectum have a vegetative aspect. There was not observed any link between the gender of the patients and the macroscopic aspect, the male gender being the majority as well as in the case of the vegetative and polypoid forms. In the case of female patients there was a preponderance of well differentiated aspect of the tumours while in the case of the male patients there was a preponderance of the moderate differentiated aspect followed by the well differentiated aspect. Although the well differentiated aspect is mainly observed at the patients coming from the urban areas there was no link observed between the histological aspect and the patient’s background. According to primary tumour the results were as follows: T1 12,18%; T2 18,27%; T3 59,19%; T4 10,39%. According to the invaded regional lymphatic ganglia the results of my study were: Nx 16,12% ; N0 24,37% ; N1 38,7% ; N2 18,27% ; N3 2,5%. Cases distribution according to distance metastasis: Mx 69,17% , Mo 12,54% , M1 18,27%. According to the differentiation level of the neoplasia the studies cases presented the following distribution: G1 18,27%, G2 56,98% , G3 24,73%. Most of the patients came to the doctor in their advanced levels of the cancer respectively stage II(30,46%) and stage III (42,65%). Patients’ distribution according to the dimension of the tumour is represented as follows: the most frequent size is of 4 - 6 cm (44,89 %) followed by 2 - 4 cm (28,57 %). Although there is noted that the tumours which are low differentiated have bigger dimensions (over 4 cm) there is no correlation between the tumour stage and its dimension.
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