2010, Number 1
Rev Med Hosp Gen Mex 2010; 73 (1)
Aquino-Pérez S, Sobrino-Cossio S, Hernández-Guerrero A, De La Mora-Levy JG, Alonso-Lárraga JO
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ABSTRACTBackground: In colorectal carcinoma (CRC) patients, obstruction at presentation has been identified in some studies as an adverse prognostic factor. Our aim was to determine if obstruction is indeed an independent factor in these patients. Methods: A retrospective study of patients with colorectal cancer with obstruction at presentation was compared to a group of patients with non-obstructing CRC. Follow-up was 36 months. Statistical analysis: for univariate analysis, Student t or chi-square tests were used as appropriate; multivariate analysis of the significant variables was then performed. Odds-ratio were also calculated for significant variables Kaplan-Meier survival curves were compared between groups. Results: A total 224 CRC patients were included. 62 patients (28%) presented with obstructive symptoms of which 19 (8.4%) had a perforation; 162 patients (72%) were non-obstructive. In patients without obstruction, chemotherapy was not associated with an improved survival. Lymph node involvement was significantly greater in non-perforated CRC (p = 0.013). There were no significant differences in the survival rate between groups. Multivariate analysis show that CEA (carcinoembryonic antigen) › 5ng/mL was an independent prognostic factor of cancer-specific survival only in patients with non.obstructive CRC (p=0.005) and OR 2.6 (IC95% 1.3-5.1). Conclusions: Obstruction was not an independent adverse prognostic factor, but CEA levels › 5 ng/mL, advanced stage (IV) and lymph node involvement were significantly associated with a poorer outcome, irrespective of the presence or absence of obstruction.