Colorectal carcinoma: Clinico-pathological pattern and outcome of surgical management

Objective: To report the pattern of presentation of colorectal carcinoma and the outcome of surgical therapy in a tertiary care hospital in Riyadh Saudi Arabia. Methods: The case reports of all patients diagnosed to have colorectal cancer were retrospectively examined for: age, sex, symptoms and clinical findings, site of primary tumour and extent of metastases, operative management, histopathology results and the outcome of surgical therapy. Results: There were forty-three (33 male, 10 female) patients, with a mean age of 42.7 years (range, 23-79 years). Sixteen (37.2%) cases presented with rectal bleeding, ten (23.2%) with abdominal pain, eight (18.5%) had altered bowel habits whereas anaemia was found to be the most frequent clinical result reported in twenty (46.4%) patients. Right side tumour was encountered in twentyone (48.8%) cases, left side tumour in twelve (27.9%) and anorectal cancer in ten (23.2%).For these lesions, thirty (69.7%) curative and thirteen (30.3%) palliative procedures were undertaken. All patients were reported to have adenocarcinomas: six (13.9%) patients had Dukes Stage A, eight (18.6%) Dukes B, twenty (46.1%) Dukes C and nine (20.9%) Dukes D. There were two post operative deaths, and four (9.3%) patients died due to tumour dissemination and cachexia, while twenty nine (67.4%) subjects had disease free survival. Conclusion: There is a substantial proximal shift of the colorectal carcinoma with more advanced lesions at the time of presentation. Surgical resection should be the mainstay treatment with potentially curable tumours.