Treatment and Outcomes of Colorectal Cancer in Armenia: A Real-World Experience From a Developing Country

Abstract

PURPOSE In Armenia, colorectal cancer (CRC) is one of the most frequently diagnosed cancers. It is in the third place by incidence. The aim of this study was to evaluate treatment and outcomes of CRC in Armenia during the last 9 years. MATERIALS AND METHODS For this retrospective hospital-based study, we have collected data from two main oncology centers in Armenia: National Oncology Center and “Muratsan” Hospital of Yerevan State Medical University. The information about patients with CRC who were treated at these two centers between January 1, 2010 and July 1, 2018 was collected from the medical records. Log-rank test and Kaplan-Meier curves were used for survival analysis. Prognostic factors were identified by Cox regression. RESULTS A total of 602 patients with CRC were involved in the final analysis. Median follow-up time was 37 months (range, 3-207 months). A total of 8.6% of patients had stage I, 32.9% stage II, 38.0% stage III, and 17.6% stage IV cancer; for 2.7% patients, the stage was unknown. The main independent prognostic factors for overall survival (OS) were tumor stage, grade, and histology. Adjuvant chemotherapy has been shown to improve survival in stage II colon cancer and stage III rectal but not in stage II rectal cancer. Radiotherapy did not yield survival improvement in stage II or III rectal cancer. Three- and 5-year OS rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages I-II, 62.5% and 48.4% for stage III, and 24.4% and 17% for stage IV respectively. CONCLUSION As seen from our results, our survival rates are lower than those of the developed world. Additional research is needed to identify the underlying reasons and to improve patients’ treatment and outcomes in Armenia.

Pathological Characteristics, Prognostic Determinants and the Outcome of Patients Diagnosed with Colorectal Adenocarcinoma at the University Teaching Hospital of Kigali

“…Though, not statistically significant ( P value = 0.255), it appears that patients with low grades tend to survive longer than high grades. This is similar to what was demonstrated by Bardakhchyan et al 2020; where tumor grade was considered as the most influential prognostic factor together with the tumor stage [ 20 ].…”

“…Overall, the results of the present study show no statistically significant (P value � 0.253) relationship between the histologic staging group and the CRC outcome where lower stage group I and II live longer with a mean of 51 months period, a finding which is similar to the one found by Bardakhchyan S et al in their 9 years retrospective study conducted in Armenian oncology center, where they found a 3-and 5-year OS rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages I-II, 62.5% and 48.4% for stage III, and 24.4% and 17% for stage IV respectively [20]. e results of the study show that Grade I survived longer than others with a mean of 47 months period.…”

Assessment of the Association between Clinical Examination and Investigations with Outcome in Cases of Abdominal Malignancy

“…Patients with suspicious malignancy may not reach the secondary care on time, or they may be reach the wrong specialty [49]. This study is in agreement with Vivek Tiwari et al, A K Dwivedi et al and Mohammed et al [50][51][52] Few other related studies were reported [53][54][55][56][57].…”

Clinical pattern and drug-related problems among colorectal cancer patients at oncology center in Ethiopia: A hospital-based study

“…This is consistent with previous studies conducted in Ethiopia (39.3%) and Armenia (38.0%), which found that stage III is more common in 39.3% and 38%, respectively. 40 , 43 Similarly, other studies have found that stage II CRC accounts for roughly one-third of all CRC diagnoses. 41 , 44 In Ethiopia, a previous study found that stage IV (47.8%) accounts for the majority of CRC diagnoses.…”