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Prognostic factors and survival in primary rectal adenocarcinoma

The objective of this study was to evaluate survival and clinicopathological factors in rectal adenocarcinoma, the records of 112 patients were reviewed for: age, gender, serum level of CEA, surgery curability, follow-up, recurrence, survival and tumor histopathology. Kaplan-Meyer curves were used to analyze survival. Statistical significance in bivariate and stratified analysis was set at P < 0.05. In the multivariate model, a 90% confidence interval was considered significant. Median follow-up was 35 (14 - 57) months. Five-year survival rate was 51%. Sixty-four patients (57%) had recurrence; 45 (40%) died from neoplasia, 68% tumors extended to perirectal tissues and 67 had positive lymph nodes (30% each, N1 and N2). Fourteen patients were Dukes D stage; 55 were C1 and C2; 15 were B2; and 28 were B1 and A. Death increased significantly with tumor progression stages (P<0.001), tumor depth (P=0.013) and grade (P=0.009), lymph node involvement (N2>N1, P<0.001) and recurrence (P<0.001). Independent prognostic factors were Dukes stages and tumor grade (P=0.089), as well as depth of invasion and lymph node involvement when Dukes staging was excluded (P=0.091 and <0.001). Besides tumor grade, the prognostic factors identified meet classification levels in current staging systems.

Rectal adenocarcinoma; prognostic factors; histopathological staging; recurrence; survival


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