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Kebede AG, Kebede T, Atnafu A. High Magnitude Advanced Colorectal Cancer at Diagnosis in Ethiopian Patients: Imaging Pattern and Associated Factors. Ethiop J Health Sci 2023; 33:81-90. [PMID: 36890929 PMCID: PMC9987274 DOI: 10.4314/ejhs.v33i1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/12/2022] [Indexed: 03/10/2023] Open
Abstract
Background Colorectal cancer (CRC) is one of the most prevalent and incident cancers worldwide with an Increasing prevalence in a younger age in developing countries. The aim of the study was to determine the staging and imaging pattern of CRC at diagnosis. Methods This is a descriptive cross-sectional study including all consecutive cases of CRC found in the departments of radiology and oncology during the study period from March 2016 - February 2017. Results A total of 132 CRC cases were studied with M: F = 2.4:1, mean age of 46yrs and 67.4% </= 50yrs. Left-sided tumors were associated with rectal bleeding (p = 0.001) and bowel habit change (p =0.045) whereas right-side tumors were associated with weight loss (p = 0.02) and abdominal pain (p = 0.004). 84.5% of CRC presented at an advanced stage, and 32% had distant metastasis. Young age was associated with the advanced stage (P=0.006) whereas family history was associated with the lower stage (P=0.008). Distance metastasis was associated with Colonic lesions (P=0.003) and emergent presentation (P=0.008). Asymmetric wall thickening with luminal narrowing was significantly associated with left side tumor (95% vs 21.4%) whereas large mass with necrosis was significantly associated with right side tumor (50% vs 5%) (P= 0.004). Conclusions CRC is presented at a younger age and at an advanced stage. The majority of CRCs were left-sided and rectal. Increasing the index of suspicion for CRC in patients with rectal bleeding and, bowel habit change is recommended.
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Affiliation(s)
- Assefa Getachew Kebede
- Department of radiology, School of Medicine, College of Health Sciences, Addis Ababa University
| | - Tesfaye Kebede
- Department of radiology, School of Medicine, College of Health Sciences, Addis Ababa University
| | - Asfaw Atnafu
- Department of radiology, School of Medicine, College of Health Sciences, Addis Ababa University
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2
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Elsayed I, Geraghty R, Mekki SO, Mohamedani AA, Ahern S, Salim OEH, Khalil BBM, Abdelrahim S, Suliman SH, Elhassan MMA, Salah SO, Salih ME, Widatalla AH, Abdelhamed OS, Wang X, Ryan ÉJ, Winter D, Bakhiet S, Sheahan K. Evaluating utility and feasibility of mismatch repair testing of colorectal cancer patients in a low-middle-income country. Sci Rep 2022; 12:10998. [PMID: 35768447 PMCID: PMC9243080 DOI: 10.1038/s41598-022-14644-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/09/2022] [Indexed: 12/24/2022] Open
Abstract
Molecular pathology services for colorectal cancer (CRC) in Sudan represent a significant unmet clinical need. In a retrospective cohort study involving 50 patients diagnosed with CRC at three major medical settings in Sudan, we aimed to outline the introduction of a molecular genetic service for CRC in Sudan, and to explore the CRC molecular features and their relationship to patient survival and clinicopathological characteristics. Mismatch repair (MMR) and BRAF (V600E) mutation status were determined by immunohistochemistry. A mismatch repair deficient (dMMR) subtype was demonstrated in 16% of cases, and a presumptive Lynch Syndrome (LS) diagnosis was made in up to 14% of patients. dMMR CRC in Sudan is characterized by younger age at diagnosis and a higher incidence of right-sided tumours. We report a high mortality in Sudanese CRC patients, which correlates with advanced disease stage, and MMR status. Routine MMR immunohistochemistry (with sequential BRAF mutation analysis) is a feasible CRC prognostic and predictive molecular biomarker, as well as a screening tool for LS in low-middle-income countries (LMICs).
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Affiliation(s)
- Inas Elsayed
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Cancer Genomics Research Center, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Big Data Research Institute, China Pharmaceutical University, Nanjing, 211198, China.,Department of Pharmacology, Faculty of Pharmacy, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Robert Geraghty
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Salwa O Mekki
- Department of Histopathology, Soba University Hospital, Khartoum, Sudan
| | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Susan Ahern
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Omer E H Salim
- Department of Surgery, Soba University Hospital, Khartoum, Sudan
| | - Balgis B M Khalil
- Department of Histopathology, Ibn Sina Specialized Hospital, Khartoum, Sudan
| | - Sawsan Abdelrahim
- Department of Histopathology, Soba University Hospital, Khartoum, Sudan
| | | | - Moawia M A Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Salah O Salah
- Department of Oncology, Khartoum Oncology Hospital, Khartoum, Sudan
| | - Mohamed E Salih
- Department of Surgery, Faculty of Medicine, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | | | | | - Xiaosheng Wang
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Cancer Genomics Research Center, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Big Data Research Institute, China Pharmaceutical University, Nanjing, 211198, China
| | - Éanna J Ryan
- Department of Surgery, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland
| | - Des Winter
- Department of Surgery, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Salih Bakhiet
- Hull Royal Infirmary, Hull University Hospital NHS Trust, Hull, East Yorkshire, UK
| | - Kieran Sheahan
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland. .,School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
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3
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Norouzi A, Besharat S, Isapanah Amlashi F, Nasrabadi M, Gharanjik I, Ashkbari A, Riahi Z, Kaabe S, Shahabi Nasab I, Roshandel G, Sohrabi A, Amiriani T, Semnani S. Detection Rate of Colorectal Polyps in Symptomatic Candidates of Colonoscopy: When Should We Do a Total Colonoscopy? Middle East J Dig Dis 2021; 13:314-320. [PMID: 36606014 PMCID: PMC9489442 DOI: 10.34172/mejdd.2021.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/08/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The incidence of colorectal cancer is increasing in the northeast of Iran. Colorectal polyps are among the proposed risk factors noted, especially in the elder population. This study was designed to study the diagnosed cases of intestinal polyps detected from 2011 to 2016 in the northeast of Iran. METHODS The population consisted of symptomatic candidates referred to the colonoscopy center in Gorgan city. Based on the available colonoscopy and pathology reports, 1706 cases were enrolled after the exclusion of cases without sufficient data. RESULTS Among 1709 (55.5% males and 44.5% females) cases, 1405 cases with 1912 polyps were detected. Among them, 345 (25%) aged less than 50 years. Tubular adenoma (N = 826, 43.2%) and hyperplastic polyps (N = 519, 27.1%) were the top two histological findings. Out of 1405 patients with polyps, 660 (39.6%) polyps were detected in proximal colon (15.6% in proximal and 24% in both proximal and distal). Malignancies were detected in 13.2% (0.8% malignant polyps and 12.4% malignant masses). CONCLUSION A considerable number of colorectal adenomas in proximal colon and in patients younger than 50 years old, suggesting to schedule colorectal cancer screening from at least 10 years younger and continuing colonoscopy up to the proximal area.
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Affiliation(s)
- Alireza Norouzi
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sima Besharat
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
,Corresponding Author: Sima Besharat, MD Golestan Research Center of Gastroentrology and Hepatology, 3rd floor, Salim heart complex, Sayyad-e-Shirazi hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran Telefax: + 98 17 32251910
| | - Fazel Isapanah Amlashi
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Nasrabadi
- Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
| | - Isan Gharanjik
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Ashkbari
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zoha Riahi
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sajjad Kaabe
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Iman Shahabi Nasab
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Sohrabi
- Infectious Disease Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Taghi Amiriani
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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Pirzada MT, Ahmed MJ, Muzzafar A, Nasir IUI, Shah MF, Khattak S, Syed AA. Rectal Carcinoma: Demographics and Clinicopathological Features from Pakistani Population Perspective. Cureus 2017; 9:e1375. [PMID: 28744422 PMCID: PMC5519317 DOI: 10.7759/cureus.1375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Colorectal carcinoma is ranked as the second most common cancer diagnosis in females and third in males. It is the third leading cause of cancer-related deaths worldwide. Disease burden has been attributed to a myriad of factors comprising genetic, environmental, and dietary factors. Rectal cancer has been shown to demonstrate variance according to the geographical location. Methods A retrospective review of 477 rectal cancer patients treated at Shaukat Khanum Memorial Cancer Hospital & Research Centre from 2006 to 2014 was performed. Demographic and clinicopathological features were compared between the two age groups (≤40 or >40 years). These included sex, ethnicity, family history of cancer, the location of tumor, clinical staging, histopathological type, and response to chemoradiation. Chi-square was used to compare the frequencies between the two age groups. p-value < 0.05 was taken as significant. Results Mean age of the study group was 44.62 ± 16.11 years. 43.8% were ≤40 years of age, and 70.2% were male. 50.3% patients belong to Punjab province, 287 (60.2%) had lower rectal cancer, family history of cancer was present in 82 (17.2%) patients. 432 (90.5%) patients had T1/T2 disease and 296 (62.1%) had N2 disease. Metastatic disease at presentation was observed in 37 (7.8%). Progressive disease was found in 90 (18%) patients. Conclusion High frequency of young onset rectal cancers and the lack of family history emphasize the need of indigenous strategies and national awareness of this disease for an early identification of these patients.
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Affiliation(s)
- Muhammad T Pirzada
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Monis J Ahmed
- Department of Surgery, Mediclinic City Hospital, Dubai, UAE
| | | | - Irfan Ul Islam Nasir
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Muhammad F Shah
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Shahid Khattak
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Aamir A Syed
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
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Haleshappa RA, Rao SA, Garg S, Kuntegowdanahalli CL, Kanakasetty GB, Dasappa L. Is Colorectal Cancer in Young (<40 Years) Different from those in the Elderly (>40 Years): Experience from a Regional Care Center. Indian J Med Paediatr Oncol 2017; 38:466-470. [PMID: 29333014 PMCID: PMC5759066 DOI: 10.4103/ijmpo.ijmpo_187_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Colorectal cancer (CRC) is considered a disease of elderly. There has been a steady decrease in the incidence in those aged >50 years, with an alarming increase noted in adults aged <50 years. Subjects and Methods: We retrospectively analyzed 89 patients diagnosed with CRC aged <40 years between the years 2010 and 2014. Their clinical profile, treatment, and outcomes were studied. Results: The median age was 33 years with a male preponderance (56.2%). Most common symptoms were lower gastrointestinal bleed (48.3%) followed by abdominal pain (46.1%). Most common sites were rectum (50.6%) followed by colon. Histology in all was adenocarcinoma. Most tumors were moderately differentiated (54%) and were stage 4 (36%). Most common sites of metastases were liver (46.9%) followed by peritoneum and ovaries. Majority underwent surgery with adjuvant chemotherapy, with/without radiotherapy. Chemotherapy was administered in 70 patients, majority receiving FOLFOX-4 regimen (88.6%). Median survival was 23 months. Survival in early stage[1],[2] was significantly higher than in advanced stages (3 and above), 34 and 19 months (P = 0.0287), in those aged >40 years compared to <40–35 versus 23 months (P = 0.0029), nonmetastatic compared to metastatic disease – 26 versus 14 months (P = 0.00196), and females compared to males – 26 and 18 months (P = 0.0242). There was no significant difference in survival with respect to tumor grade or site of metastases (hepatic versus extrahepatic). Conclusions: Colorectal carcinoma in young seems to be an emerging problem in India. Any young patient presenting with symptoms suggestive of a colonic malignancy should be evaluated promptly and treated aggressively.
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Affiliation(s)
- Rudresha A Haleshappa
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Suparna Ajit Rao
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Sunny Garg
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - Govinda Babu Kanakasetty
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Lokanatha Dasappa
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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