Детермінанти прогнозу у хворих на обструктивний рак ободової кишки

Abstract

The remote results' analysis of treatment of 202 patients, who undergone surgery for obstructive colon cancer, was carried out with the aim of determining the objective and subjective prognostic factors. In 96,5% of the cases, cancer was diagnosed primarily due to the rise of complication. The surgical operations undertaken had radical, palliative and exp!orative character in 51,5%, 4 7% and 1,5% of the patients respectively. Overall postoperative mortality was 24,2%. Five-year survival in those undergone surgery with І, ІІ, ІІІ and IV stages of neoplastic process was 71,4%, 44,2%, 4,4% and 0%. Survival indexes were analysed bу the Kaplan-Meier method. Reliability of the survival differencies of separate groups was evaluated bу the Mantel-Haenshel (logrank) test. Tumour process advance was followed bу significant deterioration of patients' survival except the groups with І and 11 stages of process. Decompressive operations only significantly worsened the remote results of treatment of the patients with 11 and ІІІ stage of the process. Segmental resection of colon in patients with ІІІ stage of tumour process lowered the survival in comparison with hemicolectomies. Tumour process stage was the objective factor of prognosis in patients with obstructive colon cancer. Oncologically inadequate surgery is the reason of Jow survival of patients with the ІІІ stage obstructive соІоn cancer