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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(01): 025-031
DOI: 10.1055/s-0041-1736517
Original Article

Diagnosis of Advanced Disease in Cases of Colorectal Cancer in a Developing Country

Ricella Maria Souza da Silva 
1   Hospital Universitário Lauro Wanderley, Unidade de Laboratório de Anatomia Patológica, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
,
Polyana Maria Cruz Collaço 
2   Faculdade de Medicina, Centro Universitário de João Pessoa, João Pessoa, Paraíba, Brazil
,
Karin S. Cunha 
3   Faculdade de Medicina, Departamento de Patologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
,
Eliane Pedra Dias 
3   Faculdade de Medicina, Departamento de Patologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
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Abstract

Objectives Colorectal cancer (CRC) is the second leading cause of cancer death in the world, with survival correlated with the extension of the disease at diagnosis. In many low-/middle-income countries, the incidence of CRC is increasing rapidly, while decreasing rates are observed in high-income countries. We evaluated the anatomopathological profile of 390 patients diagnosed with CRC who underwent surgical resection, over a six-year period, in the state of Paraíba, northeastern Brazil.

Results Adenocarcinomas accounted for 98% of the cases of primary colorectal tumors, and 53.8% occurred in female patients. The average age of the sample was 63.5 years, with 81.8% of individuals older than 50 years of age and 6.4% under 40 years of age. The most frequent location was the distal colon; pT3 status was found in 71% of patients, and pT4 status, in 14.4%. Angiolymphatic and lymph-node involvements were found in 48.7% and 46.9% of the cases respectively. Distant metastasis was observed in 9.2% of the patients. Advanced disease was diagnosed in almost half of the patients (48.1%). The women in the sample had poorly-differentiated adenocarcinomas (p = 0.043). Patients under 60 years of age had a higher rate of lymph-node metastasis (p = 0.044). Tumor budding was present in 27.2% of the cases, and it was associated with the female gender, the mucinous histological type, and the depth of invasion (pT3 and pT4).

Conclusions We conclude that the diagnosis of advanced disease in CRC is still a reality, with a high occurrence of aggressive prognostic factors, which results in a worse prognosis.

Keywords

colorectal cancer - pathological features - neoplasm staging - advanced disease


Publication History

Received: 02 April 2021

Accepted: 15 June 2021

Article published online:
18 November 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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