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2006, Number 1

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Cir Gen 2006; 28 (1)

Cancer of the rectum. Experience in its management at the General Hospital of Mexico

Jiménez-Bobadilla B, Jalife MA, Charúa GL, Navarrete CT, Osorio HRM
Full text How to cite this article

Language: Spanish
References: 13
Page: 8-13
PDF size: 84.27 Kb.


Key words:

Cancer, rectum, neoadjuvant therapy, adjuvant therapy.

ABSTRACT

Objective: To report the experience in the management of rectal cancer.
Setting: Third level health care hospital.
Statistical analysis: Percentages as summary measure for qualitative variables, chi square test for proportions, Pearson’s X2, and Fisher’s and Yate’s exact probability test.
Design: Retrospective, transversal, observational, descriptive study.
Patients and methods: We analyzed the patients with cancer of the rectum. The analyzed variables were gender, age, schooling, residence place, main symptoms, cabinet studies, and clinical staging. Besides, we compared the results of treatment with and without neoadjuvants.
Results: We studies 43 men and 54 women with rectal cancer, average age was 49.9 years; schooling level was 30% illiterate and 46% primary school. The main symptom was hematochezia, average evolution time of 10 months. Location of the tumor was: upper third, 7%; mid third, 30%; and lower third, 60%. Three patients were in clinical stage I, 15 in stage II, 52 in stage III, and 27 in stage IV. Four patients were treated only with surgery and became disease-free; 32 patients were subjected to surgery with adjuvant chemo and radiotherapy, of these, 7 presented local recurrence. In 21 patients, neoadjuvant chemo and radiotherapies were used besides surgery and adjuvant chemo and radiotherapy, 4 of them presented local recurrence. Recurrence frequency was lower in clinical stage II with neoadjuvants. General mortality was of 52%.
Conclusion: Rectal cancer is a disease with predominance in women. Level of schooling is no prognostic factor. The search for rectal cancer must start at the age of 30 years. In patients coursing with hematochezia, rectal cancer must be excluded. Treatment even in early stages must be with neoadjuvant therapy.


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Cir Gen. 2006;28