Prognostic factors in colorectal carcinoma. Multivariate analysis in 224 patients

Background: Staging of colerectal carcinoma has prognostic value and allows to take decisions about adjuvant therapy and follow up. Prognostic factors are not universally accepted and there are different staging classificatio ns. Aim: To assess the prognostic value of clinical and pathological variab les in 224 patients subjected to a curative resection of a colorectal carci noma. Patients and methods: A retrospective analysis of 99 men and 125 wome n, aged 23 to 91 years old subjected to a curative resection of a colorecta l carcinoma and followed up for a mean of 72 months. Results: Global surviv al at 60 months was 72%. Univariate analysis showed that tumor localization , vascular permeation, wall infiltration and number of involved lymph nodes had an influence on survival. A Cox regression model disclosed tumor local ization (colon versus rectum), a carcinoembrionic antigen over 30 ng/ml, va scular permeation, presence of 1 to 4 involved lymph nodes, or 5 or more ly mph nodes and the presence of an apical lymph node as variables with signif icant prognostic value. Conclusions: Our series confirms the prognostic imp ortance of lymph node involvement. This parameter is incorporated in Jass, GITSG (both modifications fo Dukes classification) and TNM staging scores.