Clinical profile and factors affecting surgical outcome of colorectal carcinoma in rural India: a study of 60 cases

Abstract

INTRODUCTIONColorectal cancer (CRC) is the second leading cause of death from cancer in western countries.1 Forty to fifty percent of patients who undergo potentially curative surgery alone ultimately relapse and die of metastatic disease.2 The most important prognostic indicator of survival in early colon cancer is the stage of the tumor, determined by the depth of penetration through the bowel wall and the number of involved lymph nodes.3 Currently 60% of malignant diseases occur in persons over 65 years of age. More than half of them are over 70 years age and one fourth of them are over 80 years old. 4 Although on a smaller scale than in the west, CRC is on important health problem in India, particularly so because of the misconceptions and ignorance those exist among the people about bowel habits and changes in them. 5,6 The five year survival rate for CRC has improved slightly over the past 20 to 30 years. 7 Although results are improved overall prognosis for patients of CRC is still same. There is greater need for early diagnosis and further identification of prognostic factors which may decide final outcome in individual case. ABSTRACTBackground: Colorectal carcinoma is the most common of the gastrointestinal tract malignancy. Aim of our study is to look for the clinical profile and factors affecting the surgical outcome of colorectal malignancy in rural India. Methods: In this study, 60 patients, whose surgery and follow up was performed by same correspondent Surgeons between years Nov 2011 to Oct 2013, were prospectively analyzed. Results: Of the 60 cases analyzed, we encountered the highest number of cases in the sixth and seventh decade in both sexes with male to female ratio 1:1. Alternating bowel habits, bleeding per rectum, giddiness and anorexia, weight loss, pain in abdomen were the most common presenting complaints with mean duration of symptoms was 6 months before diagnosis. Rectum and recto-sigmoid was the commonest site for occurrence of large bowel cancer (56.66%). Duke's system of staging with Turnbull et al modification shows majority of cases (50.00%) in category C. Well differentiated adenocarcinoma is the commonest histological pattern noted in more than half of cases. Postoperative recurrence was detected in 16.67% of cases with 33.33% of cases have not had a detectable recurrence to date. Conclusions: Rectum being the commonest site for occurrence of colorectal malignancy, diet and other predisposing factors could not be implicated in the occurrence. Age, weight loss, emergency admission, operation type, advanced stage of disease at presentation, loss of regular follow-up and lower socio-economic status of patients of rural India significantly affect the outcome of surgery.

Profile of Colorectal Cancer at Sanjiwani General Hospital, Gianyar Period January 2020 – June 2022

“…5 The rectum and rectosigmoid were the most common sites of colorectal cancer in the study of Tamgadge, et al in India (56.66%). 19 In the study by Smiddy, et where the most common location is the colon. 22 The results showed that the characteristics of of cases, respectively.…”