Rashid Mohd Radzniwan A, Aziz Aznida Firzah Abdul, Ahmad Saharuddin, Shah Shamsul Azhar, Sagap Ismail
Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2009;10(6):1163-6.
Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC.
Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records.
A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45).
Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.
结直肠癌（CRC）是全球主要的恶性肿瘤之一。在马来西亚，结直肠癌正迅速成为癌症死亡的最常见原因。其病因复杂，涉及环境和遗传因素。本研究观察了结直肠癌患者五年随访的情况及结果。
对马来西亚吉隆坡马来西亚国民大学医学中心（UKMMC）的结直肠癌患者进行回顾性病例研究。从病例记录中提取患者的社会人口学特征、治疗方式、癌症特征及五年随访结果。
共分析了107例患者的病例记录。结直肠癌发病的高峰年龄为40 - 69岁（71.1%）。男女比例为1.2:1，以华人为主（52.3%）。贫血及其相关症状包括直肠出血是最常见的临床表现。临床表现的中位持续时间为13周（四分位间距21.8）。超过三分之二的患者表现为非急诊病例（69.2%）。大多数患者表现为杜克C期（40.2%）。总体五年生存率为40%，局部复发率为19.6%。26%的患者在进行根治性治疗（手术加辅助治疗）后发生转移。华人患者的复发率（p = 0.016，比值比 = 0.205）和转移疾病发生率（p = 0.02，比值比 = 0.24）较低。几乎一半的患者未进行后续随访（43%），最常见于治疗的第一年（22.4%），而华人最不容易失访（p = 0.04，比值比 = 0.45）。
UKMMC结直肠癌患者的社会人口学特征与亚太地区相当。明显的治疗延迟导致总体生存率和局部复发率较低。
