Correlation of clinical data, anatomical site and disease stage in colorectal cancer

Abstract

Objective: to evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: retrospective observational study. Setting: Kenyatta national Hospital (KnH), nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic (lCC) and rectal (rC) lesions. the distribution of symptoms (rectal bleeding, tenesmus, change in bowel habits, abdominal pain, intestinal obstruction, rectal mass), anaemia, transfusion requirement, and the dukes' stages were compared for right colon, left colon and rectal tumours. Results: there were 54 rCC, 59 lCC, 140 rC lesions. Patient delay from onset of symptom(s) to presentation was a mean of 26.6 ± 43, 20 ± 25 and 33.7 ± 42 weeks for right, left and rectal lesions respectively (p = 0.092). the proportion of patients presenting with rectal bleeding was 21%, 44% and 79% for rCC, lCC and rC lesions, respectively. the prevalence of intestinal obstruction was 14.8%, 27.1% and 43.6% in right, left and rectal lesions, respectively. the haemoglobin levels were significantly lower for right sided lesions (p = 0.05 for right colon/rectum pair; p = 0.059 for right colon/ left colon pair). the sites of the lesions had no relationship to the stage of disease at presentation. Conclusion: in patients with colorectal cancer, the duration of symptoms was prolonged irrespective of the anatomical sub-sites. symptoms were evenly distributed across the anatomical regions except for bleeding and obstruction which predominated in rectal and left colon cancers respectively. this underlines the need for early investigations in patients with rectal bleeding, change of bowel habit, intestinal obstruction and anaemia.

Histopathological Interpretation Of Colonic Mucosal Biopsies With Clinical Correlation: A Study In A Tertiary Care Hospital Kerala

“…Rectum being the most common site of occurrence of adenocarcinoma followed by sigmoid colon. These findings were in concordance with other studies by Yawe KT et al, [23] Saidi HS et al [24] and Gurjeet K et al [29] Maximum number of cases (53.7%) were observed in the age group of 60-80 years and about 30% of cases were seen in the age group of 30-50 years, exhibiting a shift in tendency of occurrence of colorectal adenocarcinoma in younger and middle aged adults. In our study the male:female ratio was found to be 1.1:1, showing almost equal incidence among both the sexes.…”

Histomorphological Profile of Colonoscopic Biopsies - A Two Year Study in a Tertiary Care Hospital in South India

“…[19] Bleeding is an index symptom in early stage colorectal cancer, therefore it merits an urgent and full investigation, as it is a diagnostic challenge to distinguish a benign condition from a serious underlying colorectal disease on the basis of bleeding alone. Rectal bleeding was the commonest presenting symptom for malignant lesions in the present study which is in agreement with studies of Yawe KTet al [20] and Saidi HS et al [21] Majority of the neoplastic lesions were left sided, especially involving rectum followed by recto-sigmoid and sigmoid colon, similar to the findings made by Gurjeetet al [22] There is no doubt that fibreoptic colonoscopy increases diagnostic accuracy in large bowel diseases & is especially helpful in cases where radiology is either negative or equivocal. [23] Colonoscopy and colonoscopic biopsy examinations are now performed not only for the diagnosis of diseases but also for monitoring the course of wide variety of conditions and for the early detection of complications of colonic lesions.…”

Clinicopathological Review Of Colorectal Cancer

“…Bleeding per rectum was the commonest presenting symptom which is in agreement with other findings 21,22 . It has been documented that rectal bleeding especially in older patient can be predictive of colorectal cancer especially when associated with abdominal pains or change in bowel habits 23 .…”