Document Type : Research Article
Abstract
Present study is done with an aim to co-relate the clinico-pathological features with prognosis
(outcome) in patients having colorectal cancer.
The colorectal cancers usually occur in patients >50years of age (independent predictor of
poor prognosis) but can occur in younger individuals as well. There is a male predominance
in occurrence with male: female ratio of about 3:2. The majority of patients lie between the
age group of 41-70 years.
Rectal bleed, change in bowel habits, chronic abdominal pain and generalized weakness are
the common forms of presentation. Rectum is the most common site of presentation and
majority of them present with proliferative growth on colonoscopy and CECT abdomen. The
most common reported site of obstruction is the sigmoid colon.
Despite having a more advanced cancer(aggressive form), the younger patients do not have a
poor prognosis compared to the older ones. The right- sided and left sided colon cancers have
different disease charecteristics due to differences in their embryological origin.
In terms of pathological characteristics, the right- sided colon cancers have more mucinous
type cancer, more poorly differentiated tumors and more advanced TNM stage, more distant
metastasis, higher incidence of peritoneal seeding and thereby peritoneal carcinomatosis.
Patients with left- sided colon cancers have higher incidence of hepatic metastasis,
pulmonary metastasis and better survival outcomes.
Early detection strategies such as screening at a younger age may improve the survival of the
younger patients. On comparing the emergency with elective surgeries done for colorectal
cancers, the emergency colo-rectal surgeries were associated with a poorer outcome, higher
recurrence and mortality rates.