Abstract
Background: Cancer is an increasingly important public health problem in developing countries, including Sudan. The burden of colorectal cancer in Sudan is unknown, mainly because of lack of statistics or under reporting. Colorectal carcinoma is the most common malignancy of the GI tract, unfortunately there are few statistical data regarding colorectal cancer, its geographical, ethnic distribution, & pattern of behavior in Sudan.Objective: To assess pattern of presentation, management, & postoperative complication of colorectal carcinoma patients who presented to Ibn Sina hospital.Patients and method: This is a descriptive study between (2012-2014); a prospective & retrospective study of histological confirmed cases of colorectal cancer was conducted at Ibn Sina hospital.Result: Sixty three patients were included within the study. The mean age of the patients was 50.5 (±11.7). The median duration until presentation was 10 months. Left-side colonic carcinoma was 81% represented the majority of cases with Rectosigmoid cancer account for 74% of all cases. The most common presenting symptoms were alteration of bowel habits 90.5% and rectal bleeding 84%. Anemia was reported in 62.5% of right side colonic carcinoma while only in 23.5% of left colonic carcinoma. CEA was found positive in 85.3% (n=35). Postoperative morbidity in this study was 38%. All tumors were adenocarcinoma, and 65% of the sample were advanced “Duke's stage C & D."Conclusion: A younger age group with late presentation and advance disease, making the possibility of cure difficult if we take into consideration the scarcity of the resources.
Highlights
In the World Health Organization bulletin, report No.804 of 1990, it was reported that over 50 percent of cancer victims live in poor nations which have less than 10 percent of the resources for cancer care and control.(AO et al 2013) Colorectal carcinoma is the most common malignancy of the GI tract, there is few statistical data regarding colonic tumor & its geographical, racial distribution in Sudan
The anatomical subsite were categorized as cecum, ascending colon, transverse colon, descending colon, sigmoid, rectum, & multiple synchronous carcinoma, right & left sided cancer used in analysis in relation to proximal or distal location relative to the splenic flexure, the assumption is right & left-side carcinoma follow broadly different molecular pathways of carcinogenesis.(Iacopetta 2002) The diagnosis of colorectal cancer was performed by colonoscopy & histopathology examination of colonoscopy specimens
Rectosigmoid cancer account for 74% of all cases which is higher than reported throughout the literature (Cucino et al 2002). worldwide rectosigmoid carcinoma is the most frequent subsite affected, but in our study, we reported a high percentage (74%) in comparison to literature, this finding is comparable with similar studies done in Sudan,(AbdallaA & Randa 2007; Abdelrahim MI 2010; Elmasri & Boulos 1975) even malik et al 1958 point to frequency of anorectal carcinoma, this reflected no time trend change in sub-site distribution of colorectal cancer, in contrary to recent western studies which point to proximal migration phenomena, & some author find right side carcinoma in up to 40%.(Miller et al 2000; Papagiorgis et al 2014)
Summary
In the World Health Organization bulletin, report No.804 of 1990, it was reported that over 50 percent of cancer victims live in poor nations which have less than 10 percent of the resources for cancer care and control.(AO et al 2013) Colorectal carcinoma is the most common malignancy of the GI tract, there is few statistical data regarding colonic tumor & its geographical, racial distribution in Sudan. Colorectal carcinoma is the most common malignancy of the GI tract, there are few statistical data regarding colorectal cancer, its geographical, ethnic distribution, & pattern of behavior in Sudan. Objective: To assess pattern of presentation, management, & postoperative complication of colorectal carcinoma patients who presented to Ibn Sina hospital. 65% of the sample were advanced “Duke's stage C & D." Conclusion: A younger age group with late presentation and advance disease, making the possibility of cure difficult if we take into consideration the scarcity of the resources
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