Abstract 4195: Clinical, endoscopic and histological aspects of colorectal cancer at the CHU de Cocody

Abstract

Abstract Introduction: The colorectal cancer (CRC) is the 4th cancer in Côte d’Ivoire (WHO 2014). Its overall prevalence appears to be advancing in sub-Saharan Africa over the years. The CRC frequently occurs at an early age and is very often discovered at an advanced or even late stage, with a bad prognosis. Aims: To assess the clinical, endoscopic and histological aspects of CRC. Patients and methods: An observational retrospective study was conducted from the reports of lower GI (LGI) endoscopies performed at the GI Endoscopy Unit between 2008 and 2018. The diagnosis of CRC was retained on the basis of the macroscopic and/or the histological aspect of the tumor. The following parameters were collected : number and indication of LGI endoscopies, age, gender, macroscopic appearance, location and histological type of the tumor. Results: Over the study period, 2118 LGI endoscopies were carried out. We found 145 CRCs, corresponding to an endoscopic prevalence of 7%. The annual prevalence was 18,13 cases. A CRC was diagnosed every 14,6 LGI endoscopies performed. The sex ratio was 1,42. Median age was 56 years, with extremes of 14 and 92 years. Patients younger than 40 years (with a median age of 32 years) accounted for 18% of cases. Rectorrhagia was the main cause of LGI endoscopies found in 48 patients (33,1%), followed by an imaging discovery (ultrasound and/or abdominal CT scan) of a colorectal tumor in 38 patients (27,2%), abdominal pain or constipation in 15,3% of cases (21 patients), weight loss in 13 patients (9,5%), abdominal or anorectal mass in 8% of cases (11 patients), chronic diarrhea in 8% of cases (11 patients), metastatic tumor liver in 9 patients (6,6%), melaena in 4,4% of cases (6 patients) and anemia in 3 patients (2,2%). Macroscopically, rectal localization was the most common with 42,36% of cases, followed by sigmoid (36,1%), cecum (16,7%), right colon (11,8%), colon transverse (7%) and left colonic angle (2,8%). The ulcerative-budding form was the most common (88,65%), with strictures in 57,5% of cases and necrotic-hemorrhagic in 48,23% of cases; followed by the polypoid form (4,25%). There were no ulcerative and infiltrative form. The histological type was found in 30 patients (4,83%). Adenocarcinoma was the most common (93,3%). Stromal tumor was found in 3,3% of the cases. Conclusion: This work confirms that the prevalence of CRC has increased in Côte d’Ivoire, that it occurs at an early age and that it is discovered at an advanced stage. This work highlights the importance of screening for CRC as early as possible in front of a Rectorrhagia, even in young patients. Citation Format: Serge Franck Roland Fonkoua Fohom. Clinical, endoscopic and histological aspects of colorectal cancer at the CHU de Cocody [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4195.