Clinicopathological patterns and challenges of management of colorectal cancer in a resource-limited setting: a Tanzanian experience

World Journal of Surgical Oncology

Nestory Masalu¹  Eliasa Mkongo⁴  Mheta Koy²  Hyasinta Jaka²  Peter F Rambau³  Joseph B Mabula⁵  Mabula D Mchembe⁶  Phillipo L Chalya⁵ 

[1] Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Internal Medicine, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Surgery, Amana Hospital and Hubert Kairuki Memorial University, Dar Es Salaam, Tanzania;Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania

关键词: Tanzania;    Resource-limited setting;    Challenges;    Clinicopathological;    Colorectal cancer;   

Others  :  825623
DOI  :  10.1186/1477-7819-11-88

 received in 2012-11-09, accepted in 2013-03-26,  发布年份 2013

【 摘 要 】

Background

Colorectal cancer is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries, probably due to the acquisition of a western lifestyle. However, information regarding colorectal cancer in Tanzania and the study area in particular is limited. This study was conducted in our local setting to describe the clinicopathological pattern of colorectal cancer and highlight the challenging problem in the management of this disease.

Methods

This was a retrospective study of histologically confirmed cases of colorectal cancer seen at Bugando Medical Center between July 2006 and June 2011. Data were retrieved from patients’ files and analyzed using SPSS computer software version 17.0.

Results

A total of 332 colorectal cancer patients were enrolled in the study, representing 4.7% of all malignancies. Males outnumbered females by a ratio of 1.6:1. The median age of patients at presentation was 46 years. The majority of patients (96.7%) presented late with advanced stages. Lymph node and distant metastasis at the time of diagnosis was recorded in 30.4% and 24.7% of cases, respectively. The rectosigmoid region was the most frequent anatomical site (54.8%) involved and adenocarcinoma (98.8%) was the most common histopathological type. The majority of adenocarcinomas (56.4%) were moderately differentiated. Mucinous and signet ring carcinomas accounted for 38 (11.6%)and 15 (4.6%) patients, respectively. Three hundred and twenty-six (98.2%) patients underwent surgical procedures for colorectal cancer. Only 54 out of 321 (16.8%) patients received adjuvant treatment. Postoperative complication and mortality rates were 26.2% and 10.5%, respectively. The overall median duration of hospital stay was 12 days. Only nine out of 297 survivors (3.0%) were available for follow-up at the end of 5 years. Cancer recurrence was reported in 56 of 297 survivors (18.9%). Data on long-term survival were not available as the majority of patients were lost to follow-up.

Conclusions

Colorectal cancer is not uncommon in our environment and shows a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage. There is a need for screening of high-risk populations, early diagnosis and effective cost-effective treatment and follow-up to improve outcome of these patients.

【 授权许可】

   
2013 Chalya et al.; licensee BioMed Central Ltd.

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