Determinants of Survival in Cancer Rectum: Our Experience at a Tertiary Care Center

Abstract

Introduction: As per GLOBOCON 2018, colorectal cancer is the seventh leading cancer in India. Our primary aim was to look for various clinical, radiological, and pathological factors in the cancer rectum and their impact on overall survival (OS) and disease-free survival (DFS) at our tertiary care center. Materials and Methods: Nineteen patients’ clinical and treatment details were compiled from the physical records stored in the department. Calculation of median survival (MS), mean OS, and DFS was done using the Kaplan–Meier method, and the Log-rank test was applied. Results: Bleeding per rectum (84.2%), increased serum carcinoembryonic antigen (63.2%), Grade 2 adenocarcinoma (95%), ulceroinfiltrating type (57.89%), and tumor length >5 cm (73.68%), and stage III (57.89%) were most common observation. Fifteen patients underwent upfront surgery, among them 66.6% of cases had ≤12 lymph node removal. 40% (6 / 15) of patients had either proximal (n = 1), distal (n = 2), or CRM positive (n = 3) (3 / 6). The MS was 45 months, and increased mean OS, as well as DFS, was observed in patients having younger age, female sex, stage II, N0, ulcer-infiltrating tumor, tumor length <5 cm, negative margin, abdominoperineal resection, LN resected <12 but P value were nonsignificant. Conclusions: We observed that increased nodal burden, margin positivity, and advanced T in histopathology are associated with locoregional and distant failure.

Keywords

• ca rectum
• disease-free survival
• overall survival
• prognosis
• prognostic factors