Saleem Abdulaziz M, Saber Wafa, Alnajashi Rawan A, Alamoudi Ebtihal A, Shilli Yumn H, Aljabarti Amani M, Al-Hajeili Marwan
Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Internal Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.
Cureus. 2021 Sep 1;13(9):e17657. doi: 10.7759/cureus.17657. eCollection 2021 Sep.
Background Colorectal cancer (CRC) is the most common gastrointestinal cancer. In the Saudi Cancer Registry, CRC ranked as the most common cancer in men and the third most common cancer in women. Data regarding the stage of CRC at presentation and patient demographics and outcomes in Saudi Arabia are lacking. This study aimed to investigate the prevalence, survival, and mortality rates of patients with non-metastatic CRC in a tertiary care hospital in Saudi Arabia. Methods We conducted a retrospective chart review of patients diagnosed with adenocarcinoma of the colon or rectum at King Abdulaziz University Hospital between 2013 and 2017. Patients aged ≥18 years who presented with non-metastatic CRC and underwent curative resection were included. Patients with rectal cancer or metastatic colon cancer were excluded. Data on demographic characteristics, histopathological findings, tumor-node-metastasis stage, biomarkers, and surgical interventions were collected. Recurrence-free survival was defined as the time from surgery to the date of recurrence or death. All statistical analyses were performed using Stata/IC 15.1 (StataCorp, College Station, TX, USA). Results Among 260 patients diagnosed with CRC, 82 were included based on the inclusion/exclusion criteria. Among those patients, 65.9% were men and 47.5% were Saudi citizens. The mean age at the time of diagnosis was 60.8 years. Fifty-three patients (64.6%) had left-sided colon cancer. The mean tumor diameter was 52.6 mm. Most colon tumors were T3 lesions (71.3%), and 41% of patients did not have lymph node involvement (N0). Most patients (85.1%) underwent open surgery. In the multivariate analysis, only resection margin status and N stage (hazard ratio: 17.7 and 3.7, respectively) were identified as statistically significant factors affecting the recurrence-free survival. The one-, two-, and five-year recurrence-free rates were 80.5%, 66.5%, and 57.1%, respectively, and the one-, two-, and five-year and overall survival rates were 90.3%, 82.5%, and 82.5%, respectively. Conclusions We showed significant reductions in recurrence-free and overall survival within the first two years after surgical resection. Further prospective studies are needed to explore predictors.
背景 结直肠癌（CRC）是最常见的胃肠道癌症。在沙特癌症登记处，CRC在男性中排名最常见癌症，在女性中排名第三常见癌症。沙特阿拉伯缺乏有关CRC确诊时的分期、患者人口统计学和结局的数据。本研究旨在调查沙特阿拉伯一家三级护理医院中非转移性CRC患者的患病率、生存率和死亡率。方法 我们对2013年至2017年在阿卜杜勒阿齐兹国王大学医院被诊断为结肠或直肠癌腺癌的患者进行了回顾性病历审查。纳入年龄≥18岁、患有非转移性CRC并接受根治性切除术的患者。排除患有直肠癌或转移性结肠癌的患者。收集有关人口统计学特征、组织病理学发现、肿瘤-淋巴结-转移分期、生物标志物和手术干预的数据。无复发生存期定义为从手术到复发或死亡日期的时间。所有统计分析均使用Stata/IC 15.1（美国德克萨斯州大学站的StataCorp公司）进行。结果 在260例被诊断为CRC的患者中，根据纳入/排除标准纳入82例。在这些患者中，65.9%为男性，47.5%为沙特公民。诊断时的平均年龄为60.8岁。53例患者（64.6%）患有左侧结肠癌。平均肿瘤直径为52.6毫米。大多数结肠肿瘤为T3病变（71.3%），41%的患者无淋巴结受累（N0）。大多数患者（85.1%）接受了开放手术。在多变量分析中，只有切缘状态和N分期（风险比分别为17.7和3.7）被确定为影响无复发生存期的统计学显著因素。1年、2年和5年无复发率分别为80.5%、66.5%和57.1%，1年、2年、5年和总生存率分别为90.3%、82.5%和82.5%。结论 我们发现手术切除后的头两年内无复发生存期和总生存率显著降低。需要进一步的前瞻性研究来探索预测因素。
