Abstract
Background: Colorectal cancer represents a major health problem in the world today, the 3rd most common cancer and the 2nd in terms of mortality. Despite of the fact that the incidence rate remains the lowest in Africa, it is still a provider of a stronger lethality in most western countries. In Cameroon according to WHO 2018, 421 new cases (4.5% of all cancers) and 451 deaths (4.3% of all cancers) were registered. Objective: Determine the prognostics factors and the survival of patients suffering from colorectal cancer followed up in Douala. Patients and Method: This was a retrospective cohort study over a period from January 1st, 2009 to December 31st, 2018. All patients with histologically proven colorectal cancer, at the gastroenterological, oncological, anatomopathological, radiotherapy and surgery Department of Laquintinie and General Hospitals of Douala were included. The data collected were recorded and analyzed by SPSS version 25 and Excel 2016 statistical computer software. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model. The significance level was p = 0.05. Results: The median survival was 43 months CI: [35,255 - 50,745]. Survival at 1 year, 2 years, 3 years, 4 years and 5 years was 79.6%, 61.5%, 46.3%, 22.6%, 12.2% respectively. In multivariate analysis, the low degree of differentiation (HR = 16.278, p = 0.007), the presence of synchronous metastases or stage IV patients (HR = 42.004; p = 0.011) were independent factors of poor prognosis while curative surgery (HR = 0.172; p = 0.001) was an independent factor of good prognosis. Conclusion: In our study, the median overall survival was 43 months and the survival at 1 year, 2 years, 3 years, 4 years and 5 years was respectively; 79.6%, 61.5%; 46.3%; 22.6%; 12.2%. The low degree of differentiation and the presence of synchronous metastases were factors of poor prognosis while curative surgery is a factor of good prognosis.
Highlights
Colorectal cancer (1.8 million cases, or 10.2% of the total) is the third most frequently diagnosed cancer in the world and is responsible for 881,000 deaths, or 9.2% of the total, making it second in terms of mortality after lung cancer [1]
Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model
Treatment of colorectal cancer is based on surgery and chemotherapy, which can be combined with radiotherapy for rectal cancer [12]
Summary
Colorectal cancer (1.8 million cases, or 10.2% of the total) is the third most frequently diagnosed cancer in the world and is responsible for 881,000 deaths, or 9.2% of the total, making it second in terms of mortality after lung cancer [1]. A 2009 study in Morocco showed that in subjects with rectal cancer over 40 years, 5-year survival was 40% [20]. The evaluation of the management and survival by Ngo Nonga et al in patients with locally invasive rectal cancer between 2004 and 2007 showed survival at one year of 85%, at 2 years of 60% and at 4 years—42% [23]. Faced with the relative absence of recent data on prognostic factors and the survival of patients with colorectal cancer in our environment, a study on this subject becomes a necessity to supplement knowledge on this subject for a better evaluation and management of the patient. Objective: Determine the prognostics factors and the survival of patients suffering from colorectal cancer followed up in Douala.
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