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2008, Number 4

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Cir Cir 2008; 76 (4)

Predictores clínicos de etapificación en cáncer colorrectal

Márquez-Villalobos FO, Ambriz-González G, Romo-Sandoval HV, Velázquez-Ramírez GA, Álvarez-Villaseñor AS, González-Ojeda A

Language: Spanish
References: 19
Page: 311-315
PDF size: 43.47 Kb.


ABSTRACT

Objective: We undertook this study to determine the relation between symptoms as predictors of the stage of colorectal cancer (CRC).
Methods: This is a cross-sectional study performed from January 2000 to January 2005 at the “Hospital Civil Fray Antonio Alcalde”. All patients with histological diagnosis of CRC were included. Variables analyzed were gender, age, clinical manifestations and location of the tumor as well as degree of differentiation and time of evolution.
Results: We studied 108 patients with CRC. There were 52 female patients (48.1%) and 56 male patients (51.9%). Twenty five patients were ‹40 years old (23.15%). Most of the tumors were well- to mildly differentiated adenocarcinomas (88.9%). We observed 37% of proximal tumors with a median evolution time of 11.45 months. Distal tumors were observed in 68 patients with a median evolution time of 9.19 months (p = 0.20). Hemoglobin levels were lower in proximal carcinomas (p = 0.02). Advanced tumors (stages III and IV) corresponded to 82.4%. The three most common symptoms were rectal bleeding, change in bowel habits and unspecified abdominal pain. All patients showed a low sensitivity but a moderately high specificity (rectal bleeding 89%, change in bowel habits 68%). The combinations of these two symptoms to predict advanced stage were 55 and 68%.
Conclusions: The majority of the patients were diagnosed with advanced stage of well- to mildly differentiated adenocarcinomas. Evaluation of symptoms as predictors of stage showed a low sensitivity and a moderately high specificity. We attributed our results to a referral bias and to the absence of screening programs, as well as a lack of clinical judgment to diagnose CRC at earlier stages.


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