Aakif Muhammad, Balfe Paul, Elfaedy Osama, Awan Faisal Nazir, Pretorius Friedrick, Silvio Leonardo, Castinera Constantino, Mustafa Hamid
Saint Luke's Hospital Kilkenny, Kilkenny, Ireland.
Int J Colorectal Dis. 2016 Jul;31(7):1361-3. doi: 10.1007/s00384-015-2479-0. Epub 2016 Jan 7.
Colorectal carcinoma (CRC) is the second most common cancer in women and men affecting 9.7 % population worldwide. Although CRC mortality has been progressively declining since 1990 at a rate of about 3 % per year, it still remains the third most common cause of cancer deaths.
The objective of this study is to evaluate the patterns of clinical presentation, treatment options and follow-up of colorectal carcinoma.
Medical records of patients with colorectal carcinoma admitted at St. Luke's Hospital Kilkenny from January 2009 to December 2014 were included in the study.
Out of 113, 57 were males and 28 were 75 years or older. Sixty-seven percent presented in the outpatient clinic. The main presentation symptom was bleeding per rectum (40 %), followed by abdominal pain, altered bowel habit, bowel obstruction and weight loss. Mean time delay was 4.79, 6.20 and 4.83 weeks for surgical outpatient department (SOPD), colonoscopy and surgery, respectively. Ninety-eight percent of patients underwent preoperative staging with computed tomography of thorax, abdomen and pelvis (CTTAP) and 78 % had preoperative carcinoembryonic antigen (CEA) measurement. Thirty-four percent of cancers had already metastasized to distant organs. Twenty five percent underwent a right hemicolectomy. Seventy-eight percent received a primary anastomosis. Ninety-five percent achieved a R0 resection. Sixty-two percent were given adjuvant chemotherapy. Seventy-six percent had surgery follow-up and 57 % had excellent follow-up. Cancer recurred in two patients. Thirty day mortality was 2 %.
Our study shows that the mean age group at risk for colorectal cancer is 65 years (range 54-75). Still, 33 % of patients present to acute surgical assessment units with advanced disease. Though we did well in terms of operative resections, follow-up still remains a challenge.
结直肠癌（CRC）是全球男女中第二常见的癌症，影响着全球9.7%的人口。尽管自1990年以来结直肠癌死亡率以每年约3%的速度逐渐下降，但它仍然是癌症死亡的第三大常见原因。
本研究的目的是评估结直肠癌的临床表现模式、治疗选择和随访情况。
纳入2009年1月至2014年12月在基尔肯尼圣卢克医院收治的结直肠癌患者的病历。
在113例患者中，57例为男性，28例年龄在75岁及以上。67%的患者在门诊就诊。主要表现症状为直肠出血（40%），其次是腹痛、排便习惯改变、肠梗阻和体重减轻。手术门诊（SOPD）、结肠镜检查和手术的平均延迟时间分别为4.79周、6.20周和4.83周。98%的患者接受了胸部、腹部和骨盆计算机断层扫描（CTTAP）进行术前分期，78%的患者进行了术前癌胚抗原（CEA）检测。34%的癌症已经转移至远处器官。25%的患者接受了右半结肠切除术。78%的患者进行了一期吻合。95%的患者实现了R0切除。62%的患者接受了辅助化疗。76%的患者进行了手术随访，57%的患者随访情况良好。两名患者癌症复发。30天死亡率为2%。
我们的研究表明，结直肠癌的平均危险年龄组为65岁（范围54 - 75岁）。然而，仍有33%的患者因疾病进展而到急性外科评估单位就诊。尽管我们在手术切除方面做得很好，但随访仍然是一个挑战。
