Implication of late diagnosis for survival of patients with colorectal carcinoma

Darko Zdravkovic, Dragoljub Bilanovic, Tomislav Randjelovic, Marija Zdravkovic, Borislav Toskovic
2009 Vojnosanitetski Pregled  
Kliničko bolnički centar "Bežanijska kosa", Beograd Apstrakt Uvod/Cilj. Kolorektalni karcinom predstavlja jedan od najčešćih maligniteta, a ranim otkrivanjem bolesti može se smanjiti mortalitet i poboljšati prognoza. Cilj istraživanja bio je analiza uticaja kašnjenja u postavljanju dijagnoze kolorektalnog karcinoma na preživljavanje bolesnika. Metode. U studiju je bilo uključeno 119 bolesnika sa kolorektalnim karcinomom koji su operisani u Hirurškoj klinici Kliničkobolničkog centra "Bežanijska
more » ... centra "Bežanijska kosa" u periodu od 2000. do 2002. Bolesnici su bili podeljeni u dve grupe prema dužini trajanja simptoma: rano operisani bolesnici (ROB), kod kojih su tegobe trajale manje od tri meseca (n = 51) i kasno operisani bolesnici (KOB), kod kojih su tegobe trajale duže od tri meseca (n = 68). Period praćenja bio je 5 godina. Rezultati. Gubitak telesne mase, povremeni bolovi u trbuhu i gubitak apetita bili su značajno češći u grupi KOB (p < 0,01). Mlađe životno doba, krv u stolici i lokalizacija tumora na rektumu bili su češći u grupi ROB. Ukupno kašnjenje u postavljanju dijagnoze bilo je 2,19 ± 0,79 meseci kod ROB i 11,37 ± 5,68 meseci kod KOB (p < 0,01). Ukupno preživljavanje iznosilo je 44,75%. Petogodišnje preživljavanje imalo je 65,9% bolesnika u grupi ROB i 26,5% u grupi KOB (χ 2 = 28,16, p < 0,01). Gubitak telesne mase je dominatna karakteristika bolesnika koji nisu preživeli petogodišnji period (χ 2 =14,26, p < 0,01). Period od dva meseca kašnjenja u postavljanju dijagnoze predstavlja graničnu vrednost u predikciji smrtnog ishoda sa senzitivnošću 75,5% i specifičnošću 90,3%. Zaključak. Kašnjenje u postavljanju dijagnoze i stadijum bolesti visoko su značajni faktori preživljavanja bolesnika sa kolorektalnim karcinomom. U svakodnevnoj lekarskoj praksi posebnu pažnju trebalo bi usmeriti na pojavu krvi u stolici, promenu u navikama crevnog pražnjenja, bolove u trbuhu, gubitak telesne mase i sideropenijsku anemiju. Ključne reči: kolorektalne neoplazme; dijagnoza; prognoza; preživljavanje, analiza. Abstract Background/Aim. Colorectal cancer (CRC) is one of the most frequent diseases and early diagnosis has a potential role to improve survival. The aim of this study was to analyze influence of delay in diagnosis on survival in patiens with colorectal cancer. Methods. A total of 119 patients with pathohystological diagnosis of CRC were included in the study. They were operated at our Department for Surgery from 2000 to 2002. They were divided into two groups according to the duration of symptoms: early operated patients -EOP (symptoms were presented for 3 months) and late operated patients -LOP (duration of symptoms was more than 3 months). Follow-up period was 5 year. Results. Weight loss, intermittent abdominal pain and anorexia were more frequent in LOP (p < 0.01). Young age, blood in stool, and tumor localized in rectum were dominant characteristics in EOP (p < 0.05). Overall delay in diagnosis was 2.19 ± 0.79 months in EOP and 11.37 ± 5.68 months in LOP. There was highly statistically significant difference between these two groups (p < 0.01). Overall survival was 44.75%. Five years survival was 65.9% in the group of EOP and 26.5% in the group of LOP (χ 2 = 28.16, p < 0.01) Weight loss was dominant characteristics in the patients who did not survive five years (χ 2 = 14.26, p < 0.01). A period of 2 months in delay in diagnosis is "cut-off" value in prediction of death (sensitivity of 75.5% and specificity of 90.3%). Conclusion. A delay in diagnosis and stage of the disease are highly significant factors of patients with CRC survival. In everyday medical practice higher importance should be put on weight loss, intermittent abdominal pain, change in bowel habits, as well as on syderopenic anaemia.
doi:10.2298/vsp0902135z pmid:19281125 fatcat:hjnd4wrtwbfcxojiqzobdkhari