Surgical Strategies and Prognostic Significance of Lymph Node Ratio in Obstructive Colorectal Cancers

INTRODUCTION: To investigate the effect of preoperative obstruction in patients with colorectal cancer (CRC) on short and long-term outcomes and to find out the prognostic significance of lymph node ratio (LNR). METHODS: This retrospective study included patients operated for obstructive CRC under emergency conditions. Surgical outcomes and survival analysis were evaluated in all cohorts. Overall survival (OS) and disease free survival (DFS) rates were compared between patient groups according to median LNR value. RESULTS: A total of 64 patients [male (n=33, 51.6%), median age: 68.5 years] were retrieved. Median LNR was calculated as 0.09. Perioperative morbidity and mortality and curative resection rates were not different between patients with proximal and distal tumors. 5-year OS rate and median survival for all patients were 34.4% and 19 months, respectively. OS and DFS did not significantly differ between patients in early and advanced stage disease and with proximal and distal tumors (p>0.05). OS and DFS did not show significant difference in patient groups according to median cut-off LNR value (p>0.05). DISCUSSION and CONCLUSION: More objective criteria should be used while deciding on surgical strategy for obstructive distal CRCs. Although obstruction is associated with poor overall prognosis, patients who have curative resection and survive from perioperative complications have favorable long-term results. Median LNR did not show any prognostic significance for obstructive CRCs.

Tıkayıcı Kolorektal Kanserlerde Cerrahi Strateji ve Lenf Nodu Oranının Sonuçlar ve Prognoz Üzerine Etkisi

GİRİŞ ve AMAÇ: Tıkayıcı kolorektal kanserlerde kısa ve uzun dönem sonuçların değerlendirmesi ve lenf nodu oranının prognostik öneminin ortaya konması amaçlanmıştır. YÖNTEM ve GEREÇLER: Ocak 2001-Eylül 2007 tarihleri arasında tıkayıcı kolorektal kanser nedeniyle acil şartlarda ameliyat edilen hastalar geriye dönük olarak derlenmiştir. Cerrahi sonuçlar ve sağkalım değerlendirilmiş olup ortanca lenf nodu oranına göre gruplar arasında genel ve hastalıksız sağkalım karşılaştırmaları yapılmıştır BULGULAR: Toplam 64 hasta [erkek (n=33, %51,6), ortanca yaş: 68,5] hasta derlendi. Ortanca lenf nodu oranı 0.09 idi. Proksimal ve distal tümörlerde perioperatif morbidite, mortalite ve küratif rezeksiyon oranları farklı değildi. Beş yıllık genel sağkalım %34,4, ortanca sağkalım süresi 19 ay olarak bulundu. Proksimal ve dital tümörler ile erken ve ilere evre tümörlerde genel sağkalım ve hastalıksız sağkalım istatistiksel olarak farklı değildi (p>0.05). Ortanca lenf nodu oranına göre gruplar arasında genel sağkalım ve hastalıksız sağkalım açısından istatistiksel anlamlı farklılık yoktu (p>0.05). TARTIŞMA ve SONUÇ: Tıkayıcı distal kolorektal kanserlerde cerrahi stratejiye karar verirken daha objektir kriterler kullanılmalıdır. Tıkayıcı kolorektal kanseri olan hastalarda prognoz kötü olmasına rağmen, küratif rezeksiyon yapılan ve perioperatif komplikasyonları atlatan hastalar daha iyi uzun dönem sonuçlara sahiptir. Ortanca lenf nodu oranı tıkayıcı kolorektal kanserlerde prognostik anlam göstermemiştir.

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Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
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