Abstracts Colorectal Games, Rethymnom, Crete, Greece, May 2008

Abstract

Background Worldwide, the annual mortality from CRC is estimated to be 500.000. The incidence and mortality of CRC increase with age especially after 60 years of age. In Sudan there are no present population-based cancer registries that can provide database for epidemiological studies on CRC and its risk factors, for an effective implementation of the suitable screening programs. Methods A retrospective hospital-based study was conducted on all CRC patients who attended Soba University Hospital (SUH) between January 2004 and December 2007 to describe the pattern of CRC according to age, race, gender and sub-site location of the tumor. We considered that SUH is one of the largest central hospitals in Sudan that has integrated gastrointestinal and endoscopy units and receives patients from different sources of referral. Results During the study period, 202 patients with CRC attended both hospital clinical wards and endoscopy units between the ages of 10-90 years. Age was found to be independently significantly associated with both proximal and distal CRC (p=0.01). Gender and race were found to be insignificantly associated with both proximal and distal CRC (p=0.839 and 0.522 respectively). Fifty-two percent of patients were found to be of 50 years of age and below. The mean age for CRC was found to be 50 years. Almost 70% of the patients were found to have distal CRC and about 85% of them were having rectal cancer. Conclusions Fifty-two percent of the patients were found to be of 50 years of age and below with predominance of distal CRC among all patients. This gives a clue that screening with flexible sigmoidoscopy starting at the age of 40 can be of an appreciated secondary preventive value.Background Aim of the study is to assess tolerance, toxicities and results of multimodality treatment in elderly patients with rectal cancer. Methods 48 patients with rectal cancer aged over 70 years (70-84) were treated in our center. There were 31 males and 17 females with localized disease in the pelvis (19 stage II, 29 III disease, ECOG performance status 0/1 in 35 and 2/3 in 13). Nineteen patients were initially treated surgically followed by postoperative radiotherapy and chemotherapy. Twenty patients were primarily treated with radio-chemotherapy followed by surgery in 14 while 9 were treated with palliative radiotherapy because of their poor condition. Radiotherapy was 3D conformally planned and delivered with 3-field technique on 18MV linear accelerator. Post-operatively the median administered dose was 40Gy and preoperatively 45Gy. Chemotherapy consisted of orally administered capecitabine in most patients. Results Apart from 9 patients in poor general condition, we treated the rest with radical intent. Treatment toxicity was significant in both groups (post-op and pre-op radio-chemotherapy). Hematological and gastro-enteric grade II-III toxicity occurred in 80% of those treated post-operatively resulting in treatment modifications in 78%. Those treated with preoperative therapy had better tolerance; grade II-III tox...