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Abstract

Gastroenterology Medicine & Research

Factors Associated with the Occurrence of Metastatic Dissemination in Rectal Cancer

  • Open or CloseAna Lazarova*

    Department of Radiology, Medical faculty, University Clinic for surgery disease St. NaumOhridski, Macedonia

    *Corresponding author:Ana Lazarova, Department of Radiology, St.Kiril and Methodius, Medical faculty, University Clinic for surgery disease St.Naum Ohridski,Macedonia

Submission: December 21, 2020; Published: January 25, 2021

DOI: 10.31031/GMR.2021.05.000614

ISSN 2637-7632
Volume5 Issue3

Abstract

Introduction: The occurrence of metastases in rectal cancer disease is an additional important worrying factor not only in the patient but also in the surgeon due to their often fatal outcome. Up to 20% of patients with rectal cancer have metastatic disease at the stage of detection of the primary disease. Despite the development of preoperative neoadjuvant treatment, preoperative chemo-radiotherapy in rectal cancer, metastases pose a challenge in the proper management of the disease, especially as they significantly reduce the 5-year survival rate.

Aim of the study: The aim of this study is to highlight the significant factors that have influence in the occurrence of metastatic disseminated disease in the patients with primary diagnosed rectal cancer.

Material and Methods: This is a prospective study which include a 82 patients aged from 43 to 87 years, with an average age of 66 years with previously colonoscopy proven rectal cancer. Before the operation magnetic resonance images (MRI) was made at-1.5T magnet for determination the MRI T and N staging preoperatively. For detection of distant metastatic deposits, M staging, computer tomography (CT) after dynamic application of intra venous contrast medium on lungs and whole abdomen was done in all 82 patients.

Results: Metastatic deposits were found in 14 (17.07%) of 82 patients with rectal cancer disease, of them 12 were male and 2 patients were female. Eleven of the patients had metastatic deposits in the liver, 2 patients had metastatic deposits in the lung and liver at the same time and 1 patient had metastatic deposit in the peritoneum. The occurrence of metastases was significantly associated with pathohistological findings of extra mural vascular invasion EMVI (p=0.014). Metastases were detected in 78.6% (11) EMVIpositive patients and 21.4% (3) EMVI-negative patients. In the group of patients without metastases, 42.65% (29) patients were EMVI positive, 57.35% (39) were EMVI negative. Metastases were detected in one patient with T2 stage of rectal cancer, 18.2% (10) of T3 stage, most commonly and within T4 stage of rectal cancer-25% (3) patients. According to the N stage of rectal cancer metastasis were found in 3 patients N0 stage, 5 patients in N1 and also 5 in N2 and 1 patient in N3 stage of the disease. Depending on the localization of the rectal cancer in 4 patients rectal cancer was localized in the rectosigmoid part, in 4 patients in the proximal part of the rectum, in 2 patients with metastasis, rectal cancer was localized in the mid rectum and in 4 patients rectal cancer was in distal part of the rectum.

Conclusion: Rectal cancer is spread malignant disease worldwide and it is third common malignancy after breast and lung cancer in woman and prostatic and lung cancer in male population. Occurrence of metastatic dissemination when primary rectal cancer has been diagnosed is not so rare condition but is very important to be aware of the factors that are associated with metastatic dissemination of rectal cancer. Knowing the possibility of dissemination can lead to increase the 5 years survival rate and decrease the percentage of incurability.

Keywords: Rectal cancer;Metastatic dissemination;Computer tomography

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