Banca de DEFESA: OSWALDO DE MORAES FILHO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : OSWALDO DE MORAES FILHO
DATE: 23/12/2022
TIME: 14:00
LOCAL: Hospital Universitário de Brasília - Prédio da Administração - sala 4
TITLE:

COMPARATIVE STUDY BETWEEN RIGHT AND LEFT COLON CANCER: CLINICAL PRESENTATION, OPERATIVE, PATHOLOGICAL AND ONCOLOGICAL RESULTS

 

KEY WORDS:

right colon, left colon, colorectal cancer, clinical presentation, pathological staging, oncological results

PAGES: 64
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Cirurgia
SPECIALTY: Cirurgia Proctológica
SUMMARY:

Introduction: Colon cancer is one of the most incident and highest mortality in Brazil and worldwide. The colon is embryologically and anatomically divided into a right colon (RC) and a left colon (RC). Tumors in RC may be different from those in LC. RC adenocarcinomas occur more frequently in women over the age of 60 years. They also differ in clinical presentation, oncogenesis, and pathological outcomes. However, doubts still persist regarding the influence of laterality of colon tumors on oncological outcomes, that is, overall survival and disease-free survival. Objective: to analyze the influence of tumor location in the colon on clinical presentation, operative, pathological and oncological results in patients diagnosed with colon adenocarcinoma. Method: The medical records of 264 patients with colon adenocarcinoma treated at the Coloproctology Service of the University Hospital of Brasília, between January 1, 2010 and December 31, 2020, were reviewed. The sample was categorized into two groups: right colon and left colon. Epidemiological data, clinical characteristics, pathological staging, surgical treatment, operative mortality and oncological results were compared between the two groups. Nominal variables were presented in frequency and percentage and compared using the Chi-square or Fisher's exact test. Continuous variables were expressed as mean and standard deviation and compared by Student's t test or Mann-Whitney test. To assess the influence of tumor location on the studied outcomes, the Poisson regression model with robust variance (log-linear), the linear regression model and the Cox regression model were used. Results: the RC group consisted of 82 (31%) people and the LC group by 182 (69%). Mean age was similar in both groups, RC (62.20 ± 11.87) and LC, (60.13 ± 11.67) - p= 0.1866). the frequency of females was 52 (63.41%) in the right colon group and 97 (53.30%) in the left colon group. Body mass index, American Society of Anesthesiology classification, current or former smoking, frequency of arterial hypertension and Diabetes mellitus were similar in both groups. The frequency of bleeding in patients with left colon cancer was higher (PR: 0.31; CI: 0.18-0.56; p: 0.0001) and the same occurred with the frequency of change in bowel habits (PR: 0 .60; CI: 0.41-0.87; p: 0.0069). Access via laparotomy was less used in the right colon group (PR: 0.64; CI: 0.47-0.86; p: 0.0029). There were more undifferentiated tumors in the RC (PR: 0.81; CI: 0.70-0.94; p: 0.05). Disease-free survival 2.04 (CI: 0.91-4.59; p: 0.0814) and overall survival 1.36 (95% CI: 0.61-3.01 p: 0.4490) were similar in both groups. Conclusion: patients with tumors in the left colon had a higher frequency of bleeding and changes in bowel habits. There were more undifferentiated tumors in the right colon and the location of colon cancer did not influence disease-free survival and overall survival.

BANKING MEMBERS:
Presidente - 2222541 - JOAO BATISTA DE SOUSA
Interno - 154.355.041-04 - PAULO GONCALVES DE OLIVEIRA - USP
Externa ao Programa - 5296579 - ANDREA PEDROSA RIBEIRO ALVES OLIVEIRA
Externo à Instituição - MARCELO DE MELO ANDRADE COURA - SESDF