Ten years experience in colorectal carcinoma [study of 180 cases]

ABSTRACT

In this study a retro-spective analysis was performed on 180 patients with colorectal carcinoma in clinical oncology and nuclear medicine department Mansoura university hospital during the period between 1980-1990 inclusive. The relative frequency incidence of colorectal carcinomas in relation to GIT malignant tumors was 50.54% and to all malignant tumors was 3.6%. Males were almost a double fold affected more than females with peakage incidence between 40-50 years. Bowel habit disturbances were the commonest symptoms at the time of diagnosis and found in 62.22%. Radical surgery was done in 100 patients [55.56%] out of 180 patients and most of them were Dukes' C [56 patients]. Adenocarcinomas were the most histopathological type of colorectal carcinoma and constituted [52.22%]. Liver was the most commonest site of metastases and present in 47/48 patient [97.915%] of metastastic colorectal carcinomas at the time of diagnosis. The failure rate was much higher with Dukes' C patients [76.79%] than with Dukes' B patients [22.50%] as well as with radical surgery plus chemotherapy [79.61%] than with radical surgery plus radiotherapy [33.33%]. Three years survival rate was 52.50% and 35.71% for Duckes' B and C lesion respectively. Three years survival rate is much improved with radical surgery plus radiotherapy [50.00%] than with radical surgery plus chemotherapy [29.17%]. Toxicity to chemotherapy was mild and was mainly on haemopiotic system and toxicity to radiotherapy was also mild and was mainly radiation dermatitis and dysuria. It seems from this analysis that radiotherapy is essential following surgery to decrease the incidence of local failure and so selection of patients is important to determine the effectiveness of treatment i.e. Dukes'A and early cases of Dukes' B are unsuitable for adjuvant treatment while late Dukes' B cases and Dukes' C cases are at high risk of recurrence and will be benefit with adjuvant treatment