Problems of staging complicated forms of colon carcinoma in patients who were urgently operated in a general surgical hospital

Authors

DOI:

https://doi.org/10.14739/2310-1237.2023.1.273868

Keywords:

intestine, large, cancer, surgical pathology, morphological and microscopic findings

Abstract

The aim of the study: to analyze the results of surgical treatment and pathomorphological examination of preparations of patients who were urgently operated on for complicated forms of colon cancer, and to assess their influence on the correct staging of the tumor process in the postoperative period.

Materials and methods. An analysis of data from pathomorphological studies of 71 (100 %) patients who underwent treatment at the surgical department for complicated forms of colon cancer was carried out.

Results. Colon adenocarcinoma was detected in all 71 (100 %) patients (mucinous adenocarcinoma in 3 (4.23 %) patients, and the rest 68 (95.77 %) – unspecified adenocarcinoma). 44 (61.97 %) patients were diagnosed with moderately differentiated adenocarcinoma of the colon, 25 (35.21 %) – with poorly differentiated, and 2 (2.82 %) – with highly differentiated tumors.

Conclusions. In the case of surgical interventions for complicated forms of colon cancer, lymphatic dissection in the minimum extent (D1) was performed in 54 (76.06 %) patients, and 17 (23.94 %) patients were operated on without removal of lymph nodes. The insufficient level of performing lymphatic dissections in patients with complicated forms of malignant pathology of the large intestine does not make it possible to assess the real picture of metastatic lesions of regional lymph nodes and to assign the correct stage of pN according to TNM 8 (in 17 (23.94 %) patients, no pathomorphological assessment was performed at all, and in 40 (56.34 %) patients, the number of examined lymph nodes were not indicated in the preparation). In the structure of staging of oncopathology, in 12 (16.90 %) patients, the stage of cancer was assign only according to the criterion of the degree of invasion (T) and in 5 (7.04 %) patients – only according to the data of instrumental examination and intraoperative revision (clinically), and was overestimated. Lack of a clear consistent assessment of the macroscopic, microscopic, immunohistochemical and molecular characteristics of the tumor process in 17 (23.94 %) patients leads to inaccuracies in the assessment of the stage of the tumor process, which in turn affects the prognosis for relapse and survival of the patient, and the tactic of postoperative treatment.

Author Biographies

M. A. Kubrak, Zaporizhzhia State Medical University, Ukraine

PhD, Аssistant of the Department of General Surgery and Postgraduate Surgical Education

S. M. Zavhorodnii, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of General Surgery and Postgraduate Surgical Education

M. B. Danyliuk, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of General Surgery and Postgraduate Surgical Education

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Published

2023-04-28

How to Cite

1.
Kubrak MA, Zavhorodnii SM, Danyliuk MB. Problems of staging complicated forms of colon carcinoma in patients who were urgently operated in a general surgical hospital. Pathologia [Internet]. 2023Apr.28 [cited 2024Jun.13];20(1):45-9. Available from: http://pat.zsmu.edu.ua/article/view/273868

Issue

Section

Original research