[Long-term results after surgery for colorectal adenocarcinoma, stage I-III. Problems of prognosis].
Colorectal cancer is one of the leading causes of cancer-related death worldwide.


METHODS
Prospective study on 142 consecutively cases with stage I to III colorectal adenocarcinomas (TNM AJCC/UICC) in which patients underwent potentially curative surgery in one single public health service (1st Surgical Clinic Iaşi, Romania) between 2004 and 2005.


METHODS
The mean follow-up was 23.26 +/- 9.78 months (range 2 to 42 months). There were 85 men (59.9%) and 57 women (40.1%) with mean age 63.38 +/- 11.84 years (range 28 to 88 years). The surgical procedures performed were the following: right colectomy (n = 54; 30%); transverse colectomy (n = 2; 1.4%); left colectomy (n = 19; 13.4%); segmental colon resection with anastomosis (n = 5 ; 3.5%); Hartmann procedure (n = 18; 12.7%); anterior rectal resection (n = 11; 7.7%) and abdominoperineal resection (n = 33; 23.2%). With regard to postoperative adjuvant therapy most patients were given chemotherapeutic agents such as 5-fluorouracil and folinic acid. The mean overall survival (months) and 42-months survival rates were calculated. The patients were censored in the survival calculation (Kaplan-Meier method) and Cox regression if they were alive at the endpoint of the follow-up. Some patients were censored because they were "lost to follow-up". Statistical significance is p < 0.05.


RESULTS
The factors with a significant negative influence in overall survival and 42-months survival rates were: the age over 70 years, the emergency surgery related to cancer's complications, the advanced AJCC/ UICC stage, vascular invasion, perineural invasion, the recurrence of disease, the moderate and lower differentiated adenocarcinoma and incomplete or not performed chemotherapy.


CONCLUSIONS
Even with a radical surgical approach the advanced stage of colorectal adenocarcinoma has a low prognostic, but some other factors have also a high significance in postoperative outcome. Related to other prognostic factors we performed a review of literature.
Georgescu
St O
SO
Clinica I Chirurgie, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr.T. Popa", Iaşi.
Neacşu
C N
CN
Vintilă
D
D
Popa
Paula
P
Forţu
Liliana
L
Nistor
A
A
Ferariu
D
D
Târcoveanu
E
E
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012383:Romania; D016019:Survival Analysis; D016896:Treatment Outcome