Correlations of Sociodemographic and Clinicopathological Features with Survival Outcome of Colorectal Cancer: A Retrospective Study from A Libyan Cohort

Abstract

Aims. To study the correlations of sociodemographic and clinicopathological variables of patients with colorectal cancer (CRC) and the association of these variables with patients' outcome. Methods. A retrospective analysis of 466 patients with CRC were diagnosed and treated at the National Cancer Institute (NCI), Misurata, Libya during the 2008-2017 period. Data for sociodemographic, clinicopathological, biological variables, presentation, treatment, and survival related data were collected from the patients' records. Results. The mean age of patient was 53.2 years (range 22-90 years) and most of patients (60.9%) were aged > 50 years. For gender distribution, CRC was nearly the same frequent among males and females (50.2% and 48.9%, respectively). Intestinal obstruction was the most frequent presentation (41.6%) followed by bleeding per rectum (34.1%). Colon cancer was more common than those located in the rectum, (60.1% vs. 39.9%), %), left sided tumours (35.4%) was more frequent than right colon (24.7%). Most tumours were adenocarcinoma (82.0%) and most of patients had moderate differentiated tumours (60.5%). In term to the AJCC staging system, the distribution of stages was as follows: 4.9% stage I, 25.4% stage II, 40.3% stage III, and 29.4% stage IV. Liver was the most common metastatic site (70.5%). In the overall population (median follow-up 46 months), patients with <50 years of age, with an advanced stage and with a high-grade tumour had shorter survival times than those with ≥50 of age, early stage and low-grade tumour (p <0.0001, p <0.0001 and p <0.0001, respectively). Disease-free survival (DFS) was better in patients with old age (p <0.0001), early stage (p <0.0001) and low-grade tumour (p <0.0001). In a Cox multivariate analysis, clinical stage (p<0.0001) and age at diagnosis (p =0.017) were independent predictors of overall survival, and clinical stage (p <0.0001) and age at diagnosis (p =0.019) also proved to be independent predictors of DFS. Conclusion. The present Libyan cohort of CRC shows that the mean age at diagnosis was 52.3 years with equal gender distribution. Colon cancer was more frequent than rectum cancer. Most patients had tumours that were adenocarcinoma, moderate grade and most presented with stage III. Liver was the commonest metastatic site. Clinical stage was powerful independent predicators of patients' outcome and DFS.