Prognosis of colorectal cancer in Tikur Anbessa Specialized Hospital, the only oncology center in Ethiopia

Abstract

Introduction: Colorectal cancer is the third most commonly diagnosed cancer in males and the second in females worldwide. According to the Addis Ababa cancer registry, it is the first in male and fourth in female in Ethiopia. However, there have not been studies on prognostic factors and survival of colorectal cancer. Hence, this study aimed to estimate survival time and identify prognostic factors.

Methods: In this institution based retrospective study, medical records review of 422 colorectal cancer patients and telephone interview was used as sources of data. Survival time was estimated using Kaplan-Meier estimator. Prognostic factors were identified using the multivariable Cox regression model.

Results: Patients diagnosed with rectal cancer had 76% (HR: 1.761, 95% CI: 1.173-2.644) increased risk of dying compared to colon cancer patients. Node positive patients were 3.146 (95% CI: 1.626-6.078) times likely to die compared to node-negative and metastatic cancer were 4.221 (95% CI: 2.788-6.392) times likely to die compared to non-metastatic patients. Receiving adjuvant therapy reduced the risk of death by 36.1% (HR: 0.639 (95% CI: 0.418-0.977)) compared to patients who had an only surgical resection. The median survival time was 39 months and the overall five years survival rate was 33%.

Conclusions: The overall survival rate was low and a majority of the patients were young at presentation. Patient's survival is largely influenced by the advanced cancer stage at presentation and delays in the administration of adjuvant therapy. Receiving adjuvant therapy was among the good prognostic factors.

Fig 1. Overall survival probability of colorectal cancer patients in TASH, Addis Ababa, Ethiopia, 2012–2016.