Metanálise -invasão perineural como fator prognóstico no câncer retal

Relatos relevantes publicados entre janeiro de 1980 e dezembro de 2017 foram buscados nas bases de dados Medline (PubMed, Ovid), Embase e Cochrane Library. Todos os ensaios clínicos que avaliaram a IPN no câncer de reto, estudos observacionais prospectivos, dados de registro clínico e séries de casos retrospectivos que relataram IPN como um desfecho foram incluídos. Relatos de casos, resumos, cartas e comentários foram excluídos. A razão de risco (hazard ratio [HR]) com intervalo de confiança (IC) de 95% foi usada para determinar o valor prognóstico.

Resultados:

Foram analisados 19 estudos compreendendo 6.438 pacientes com câncer retal. Os resultados indicam que a invasão perineural é um fator prognóstico negativo, conforme demonstrado pela sobrevida global (HR = 1,30; IC 95%: 1,13-1,50; p < 0,01) e sobrevida livre de doença (HR = 2,14; IC 95%: 2,06-2,22, p < 0,01).

Conclusão:

O estudo demonstrou que a presença de invasão perineural está associada a um prognóstico ruim no câncer retal.

Palavras-chave:
Câncer retal; Invasão perineural; Sobrevida; Prognóstico

References	Year published	Country	N	Study design	M/F	Med age (years)	Follow up mean ± SD	Number PNI +ve (%)	Neoadjuvant treatment	TNM edition	Stage grouping	Outcome	JS^a a A, all the patients undergo treatment; AJCC, American Joint Committee on Cancer; DFS, disease-free survival; N, none of patients accept the therapy; NR, not reported; OS, overall survival; S, some of the patients undergo treatment; PNI+, rectal cancer with perineural invasion; R, rectum; SD, standard deviation; UICC, Union for International Cancer Control.
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[1] *Corresponding author. E-mail: mjrexels@gmail.com (J.R.Murugesan).