Analytical study of Fifty Cases of Colorectal Malignancies

INTRODUCTION: Colorectal cancers though most common in the west are on the increase in our country for the past decade. The early detection of the disease is of paramount important in its out come few topics in cancer research have engendered more excitement, the recent discovery of identifiable genetic defect in patients with inherited as well as sporadic form of colorectal cancer. AIM OF STUDY: To study the pattern of: 1. Incidence, Age, Sex and site. 2. Etiopathogenesis. 3. Clinical presentation. 4. Treatment modalities. 5. Adjuvant therapy. 6. Role of minimal access surgery. 7. Recent advances in management. 8. Follow up of colorectal carcinoma in Govt. Royapettah Hospital, Chennai. MATERIALS AND METHODS: Cases of colorectal carcinomas collected during the period of September 2004 to August 2006 of 24 months are utilized for this Study. A total No. of 50 cases of which 8 presented as Emergencies. Detailed history was elicited from each patient with special preferences to family history habitations and early symptomatology. Thorough physical examination was performed for evaluation of General condition, detection of signs and per rectal examination for all patients. Thorough lab investigation were done in every patient except those who presented Emergencies underwent contrast radiographic studies. Colonoscopic evaluation and CT abdomen done in selected cases. Chest x-rays taken for all patients for preoperative evaluation as well as detection of secondaries. Liver function test done as a routine test to assess nutritional status of patient. For all possible cases, preoperative biopsy taken via proctoscopic, colonoscopic guidance and histologic type made out before planning treatment. Detailed Histopathological reports were available for staging tumor and assessing the grade differentiation. CONCLUSION: 1. Incidence of colorectal carcinoma is on the increase in the past few years. 2. There is no definitive evidence to say that diet rich in fat is risk factor. 3. Commonest age group of colorectal carcinoma was 5 - 6th decade, (middle age and elderly age). 4. The incidence was slightly higher in male M : F 1:5:1. 5. Ca rectum was most common site of large bowel in this study (46%). There is also an increase incidence on the right side of colon (36%). 6. More patient presented to us with advanced stage considering bleeding PR and altered bowel habits as Haemorrhoids, as it is known by that only 2% of patient presented in Duckes Stage A. 7. 16% of patient presented with acute emergency in the form of intestitnal obstruction. 8. Surgery is the main modality of treatment which is palliative or curative. 9. To conclude any patient of middle and elderly age group who presenting with bleeding PR and altered bowel habits should be investigated thoroughly with per rectal, proctoscopic or sigmoidoscopic examination. Patient presenting with advanced stage had poor prognosis. 10. Role of minimal access surgery in colorectal malignancy is vital as in upgrading stage, less morbid procedure, early recovery to work etc. 11. Hence patients must be educated about the symptom and etiology of colorectal malignancy and importance of screening in those with family history, in order to get a earlier treatment and better outcome for both the surgeon and patient alike