Pattern and Management of Colorectal Malignancies In St. Paul’s Hospital Millennium Medical College: a two year Retrospective Study

Abstract

ABSTRACT Background: Colorectal cancer is the most common malignancy of the gastrointestinal tract. Aging is the dominant risk factor for colorectal cancer, with incidence rising steadily after age 50 years. The majority of patients presenting with symptomatic CRC have hematochezia or melena, abdominal pain, otherwise unexplained iron deficiency anemia and/or a change in bowel habits. Surgical resection is the primary treatment modality for CRC, and outcome is most closely related to the extent of disease at presentation. Objective: This study aims to assess the frequency of colorectal malignancies; the common presenting symptoms and signs; the site, stage and histology; and management options of colorectal malignancies in SPHMMC. Method: A hospital based retrospective cross-sectional study design, by reviewing of patient records from January 1st 2016-December 31st 2017 was used. Patient card numbers with colorectal cancer were retrieved from registry log book in the department of surgery. Individual patient cards were retrieved from the hospital record office. A total of 101 out of 112 patient cards were included in the study. Data were entered and analyzed using SPSS for windows version 22, and descriptive data analysis using frequency was made to answer the research question. Results: 57.4% (58/101) were male and 42.6(43/101) were female. Majority of patients were in the age group 60-69years, 29.7% (30/101), and 25.7% (26/101) of cases were below the age of 40 year. The main presenting symptoms were abdominal pain (71.3%, 72/101), and rectal bleeding (52.5%,53/101); and the most common presenting signs were mass on DRE(42.6%, 43/101), and signs of large bowel obstruction(30/101, 29.7%). 42.6%(43/101) of the tumors were located in the rectum; 14.9%(15/101) in the descending colon; 11.9%(12/101) in the rectosigmoid junction; and 9.9%(10/101) in the sigmoid colon. Histopathology was performed in 83 of the patients, and all of them (100%, 83/83) were reported to be adenocarcinoma. Majority (24.8%, 25/101) of cases were stage II, followed by stage III(16.8%, 17/101). APR and left hemicolectomy were the most commonly performed procedures among elective cases; and sigmoid loop colostomy and right hemicolectomy were the most common procedures in emergency patients.