ThTP4.5 Outcomes of colorectal cancers can be improved - 10 year Results from a South Asian Tertiary Center

Abstract

Abstract Introduction Colorectal cancers are the most common gastrointestinal cancers and continue to rise in numbers. We aimed to compare the outcomes of all colorectal cancers after a five year period of change in practice. Methods We compared the demographic, clinical, treatment, and outcomes parameters of all rectal cancer patients registered at our hospital in the year 2013 to those in 2018. A total of 1442 patients, 511 in 2013 and 931 in 2018 were included. Results Median age reduced from 46 years to 40 years, with the proportion of young rectal cancers (≤45 years) increasing from 49% to 70% in 2018. A shift towards low rectal cancers, poorly differentiated and signet-ring cell histology was also observed in 2018. More patients in 2018 presented with advanced T and N stage with similar rates of distant metastatic disease at initial diagnosis. Curative intent treatment was offered to 1179 patients, and neoadjuvant radiation was offered to similar proportions with an increasing use of short-course radiation in 2018. Higher default and progression rates were observed in 2018 (30.2% vs 40.8%), and fewer patients could receive definitive surgery. At a median follow up of 96 months for the 2013 group and 32 months for the 2018 cohort, the 3-year OS was 47.5% and 73.3% for the 2013 and 2018 registered patients, respectively. Conclusions The increase in survival for every stage of rectal cancer in five years interval despite more advanced and aggressive tumours, suggest the augmentation and improvement in services offered at the colorectal unit.