Estudio de los factores pronósticos de cáncer colorrectal en estadio I-III
- GALLARIN SALAMANCA, ISABEL MARÍA
- José Miguel Morán Penco Director
- María Teresa Espín Jaime Co-director
- Manuel Molina Fernández Co-director
Defence university: Universidad de Extremadura
Fecha de defensa: 05 May 2018
- Fernando Noguerales Fraguas Chair
- Luis González Bayón Secretary
- Francisco Javier Sáenz de Santamaría Morales Committee member
Type: Thesis
Abstract
OBJECTIVE. This study aimed to evaluate the independent prognostic factors for disease-free survival (DFS) and cancer-specific survival (CSS) in patients with stage I-III colorectal cancer and to study the role of new prognostic factors, such as preoperative inflammatory status and cytology of the peritoneal lavage. Construct two nomograms to predict DFS and CSS, which include clinical, histologic and serologic characteristics, with rigorous validation. METHODS. Retrospective study, 288 patients with colorectal cancer stage I-III, and prospective study, 118 patients to analyze the role of peritoneal lavage cytology. RESULTS: In multivariate Cox regression analysis, N stage, platelet-lymphocyte ratio and perineural invasion, were independent prognostic factors for DFS, and N stage, platelet-lymphocyte ratio and blood in stool, were independent prognostic factor for CSS. CONCLUSION. There are new prognostic factors in patients with stage I-III colorectal cancer, the preoperative inflammatory state and the blood in stool. Cytology of peritoneal lavage to detect free tumor cells in patients undergoing curative resection for colorectal cancer is not a useful tool in a large group of patients with colorectal cancer. It is important to construct predictive nomograms with clinical, histological and analytical characteristics to guide health professionals in the management of patients with colorectal cancer.