TITLE:
Prognostic Factors and Survival of Colorectal Cancer in Cameroun: A Retrospective Hospital-Based Study
AUTHORS:
Jean Paul Engbang, Fabien Bekolo Fouda, Ulrich Chanwa, Marcelin Ngowe Ngowe
KEYWORDS:
Colorectal Cancer, Prognosis, Survival, Douala
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.11 No.3,
March
12,
2021
ABSTRACT: Background: Colorectal cancer represents a major health problem in the world today, the 3rd most common cancer and the 2nd in terms of mortality. Despite of the fact that the incidence rate remains the
lowest in Africa, it is still a provider of a stronger lethality in most
western countries. In Cameroon according to WHO 2018, 421 new cases (4.5% of
all cancers) and 451 deaths (4.3% of all cancers) were registered. Objective: Determine the prognostic factors and the survival of patients suffering from
colorectal cancer followed up in Douala. Patients and Method: This was a
retrospective cohort study over a period from January 1st, 2009 to
December 31st, 2018. All patients with histologically proven colorectal cancer, at the gastroenterological,
oncological, anatomopathological, radiotherapy and surgery Department of
Laquintinie and General Hospitals of Douala were included. The data collected
were recorded and analyzed by SPSS version 25 and Excel 2016 statistical
computer software. Survival was determined by the Kaplan Meier method and the
search for prognostic factors was carried out
using the Cox proportional hazards model. The significance level was p =
0.05. Results: The median survival was 43 months CI: [35,255 - 50,745]. Survival at 1 year, 2 years, 3 years, 4 years
and 5 years was 79.6%, 61.5%, 46.3%, 22.6%, 12.2% respectively. In multivariate
analysis, the
low degree of differentiation (HR = 16.278, p = 0.007), the presence of synchronous
metastases or stage IV patients (HR = 42.004; p = 0.011) were independent factors
of poor prognosis while curative surgery (HR = 0.172; p = 0.001) was an
independent factor of good prognosis. Conclusion: In our study, the
median overall survival was 43 months and the survival at 1 year, 2
years, 3 years, 4 years and 5 years was respectively; 79.6%, 61.5%; 46.3%;
22.6%; 12.2%. The low degree of differentiation and the presence of synchronous
metastases were factors of poor prognosis while curative surgery is a factor of
good prognosis.