PROGNOSTIC FACTORS IN COLORECTAL-CANCER - LITERATURE-REVIEW FOR CLINICAL-APPLICATION

PURPOSE: Identification of prognostic factors is a primary basis for p lanning the treatment and predicting the outcome of patients with colo rectal cancer. Reviewing studies from the literature performed using u nivariate and multivariate analyses and their own study, the authors c ritically discuss the prognostic value of the clinicopathologic parame ters of the tumor. METHODS: Among 853 patients with colorectal tumors seen at the Department of Clinical Surgery of the Catholic University of Rome, Italy, 690 cases that were curatively resected entered the st udy. Overall survival rate, related to the clinicopathologic variables , was calculated, and univariate and multivariate analyses were per fo rmed. RESULTS: Five-year and ten-year overall survival rates were 70 a nd 55 percent, respectively. Univariate and multivariate analyses show ed that node involvement, distant metastases, bowel obstruction, and p atient gender are factors independently related to outcome. CONCLUSION S: Data from the literature and the present study suggest that only a few clinical parameters, particularly bowel obstruction, and some path ologic factors (tumor stage, vessels invasion, and tumor ploidy) are r elated to patient survival rate and are the most reliable prognostic c riteria. In prospective clinical studies, any other new pathologic or molecular factors should be matched with these parameters to confirm t heir value in outcome prediction.