Dados do Resumo

Título

Macroscopic findings of surgical specimens from patients with colorectal cancer treated at an oncology reference center in northern Brazil

Introdução

Colorectal cancer (CRC) is common in Brazil, with an estimated 21,970 cases in men and 23,660 in women annually until 2025. Left-sided tumors have higher incidence, while right-sided ones show unique histopathological traits and tend to a poorer prognosis. The average age at diagnosis is 40 years for hereditary cases and 67 years for sporadic ones. CRC adenocarcinoma typically has elevated borders and an ulcerated center; extensive dissection of pericolic fat is needed to identify lymph-nodes.

Objetivo

Describe the age of patients and macroscopic findings of surgical specimens, including: preservation method; anatomical position, color, tumor characteristics and extent; and nodular structures.

Métodos

This descriptive cross-sectional study was conducted at the 'Fundação Centro de Controle de Oncologia do Estado do Amazonas' (FCECON). It was part of the larger project 'ANALYSIS OF THE MOLECULAR AND CLINICAL SPECTRUM OF COLORECTAL CANCER: FROM EPIDEMIOLOGY AND QUALITY OF LIFE TO GENETICS AND OMICS ANALYSES' (EMCOR), which aimed to characterize clinical, epidemiological, immunological profiles, cellular and molecular aspects, and assess quality of life in patients with suspected or confirmed colorectal cancer. Approved by the Research Ethics Committee (5.180.654) of FCECON in 2021. The final sample included 55 patients with colorectal adenocarcinoma, from January 2022 to July 2024, recruited through spontaneous demand from the institution's outpatient service. Post-surgery's specimens were sent to the pathology lab for macroscopic examination by the pathologist, while a study collaborator recorded the variables.

Resultados

Data from 55 histopathological reports were collected. Of the participants, 85.6% were over 50, and just under 15% were 50 or younger. Regarding tumor laterality, approximately 65% were in the left colon and 35% in the right. Among patients 60 or younger, 68% were in the left colon and 32% in the right. For those over 60, 67% were in the left colon and 33% in the right.
For macroscopic analysis, 35 specimens were received fresh, and 20 in formalin. The mean, mode, and median of the surgical specimen lengths were 27.65 cm, 25.0 cm, and 25.0 cm, respectively. The largest specimen was 75.0 x 7.0 cm (total colectomy), and the smallest 9.0 x 6.0 cm (rectal resection). Tumor colors varied: wine-colored (14.5%), whitish (14.5%), light brown (10.9%), dark brown (7.3%), and grayish (3.6%), with color unassessed in just over 49% of cases. Lesion patterns were mostly vegetative (47.3%), followed by ulcerated (27.3%), exophytic (12.7%), ulcerative-vegetative (7.3%), and others (5.4%). Nearly 55% of the tumors were at least 5.0 cm, with the largest measuring 14.0 cm. Nodular lesions were present in 78.2% of specimens, with 67% having fewer than 12 nodules.

Conclusões

The study concludes that 86% of patients diagnosed with CRC were 50 years old or older at the time of surgery. Tumors in the left colon were predominant (65%). Lesions varied in color, size, and pattern, with most being vegetative and measuring at least 5.0 cm. Nodules were common, present in 78.2% of samples. These macroscopic findings and age analysis help better understand the clinical profile of colorectal cancer in the Amazon region.

Palavras Chave

Colorectal Neoplasms; Surgical Pathology; Macroscopic findings