Prognostic factors and outcome of surgical management and adjuvant chemotherapy of advanced stage colorectal cancer: a single institution experienc

Introduction: Colorectal cancer is the 3rd common cancer and the 4th cause of cancer-related death worldwide. Stage II and III define locally advanced colorectal cancer while stage IV represents a metastatic stage according to the AGCC staging system. Locally advanced colorectal cancer is more difficult to treat as multi-visceral resection is often required(1). Patients and methods: Data collected included all clinicopathological features (age, sex, TNM stage, pathological subtype, grade, pre-and post-operative CEA and CA19-9) surgery details (type, organs resected, lymph node status, surgery dates, intraoperative and postoperative morbidity, and mortality) as well as the neoadjuvant or adjuvant therapy (regimen, cycles, toxicity). Results: Forty-eight procedures (61.5%) were considered curative (R0 resections, without residual tumor and 30 (38.4%) were palliative (R1 resections, with microscopic residual tumor or R2 resections, with macroscopic residual tumor). Most of the cases(n=58cases,74.4%) received adjuvant chemotherapy with an oxaliplatin-based regimen (82.8%) and a toxicity rate of 31.0% (n=18,). Conclusion: Achievement of R0 resection and negative surgical margin are essential for cure. The multiorgan resection does not affect the survival outcome. Only male sex, advanced stage of the disease showed a negative prognostic factor with the overall survival while adjuvant chemotherapy is a good prognostic factor for a better survival outcome. National screening programs should be implemented to help diagnosing colorectal cancers in earlier stages and achieve cure with the least intervention.