Assessment of adequacy of surgical resection for colorectal cancer at Tikur Anbessa specialized hospital from2016-2019, Addis Ababa, Ethiopia.
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Date
2020-10
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Addis Abeba University
Abstract
Background: Colorectal carcinoma is a malignant neoplasm of the colon and rectum. It is the
most common malignancy of the gastrointestinal tract. The enbloc removal of the presenting
malignancy, to include adequate margins plus the lymphatic nodal basin, remains the hallmark of
surgical treatment for cure. Adequate lymph node evaluation is required for proper staging of
colorectal cancer, and the number of lymph nodes examined is associated with survival
Objectives: To determine the adequacy of surgical resection of patients operated for colorectal
cancer at Tikur Anbessa Specialized Hospital.
Methods: A retrospective cross-sectional study was conducted by a review of the medical
records of all patients who had undergone resection of colorectal cancer at Tikur Anbessa
Specialized hospital from January 1, 2016 to December 31, 2019. The data was obtained from the
patient’s record review; data was collected using a pretested questionnaire and checklist. Data were
checked and entered into Epi data version 3.1 then exported to statically package for social science
version 24 for analysis.
Result: From the total of study participants above the half 48(53.3%) are male, with male to
female ratio of 1.14:1. The majority 44(48.9%) of study participants were found in the age groups
of <50 years followed by 50-64 years 26(28.9%).The mean of LN harvested was 10.35(SD ±7.86)
with a maximum of 41 and a minimum of 0.And only40% of patients had Adequate LN harvested
(≥12). female patients were 2.12 times more likely to have adequate LN harvested as compared to
male patients with AOR=2.12(1.49-3.96). Similarly, patients found in the age group of ≥65 were
less likely to have adequate LN harvested as compared to patients found in the age group of <50
years with AOR=1.22 (1.60-4.88). Those patients with an age group of ≥65 years were 2.04 times
more likely to have radial Margin involvement as compared to others, while fixed tumors are 2.81
times more likely to have radial margin involvement relative to mobile tumors.
Conclusion: In this retrospective study, we described the adequacy of nodal harvest in colorectal
cancer and evaluated possible factors that may affect the adequacy nodal harvest. Only 40 % of
the patients in this study have adequate nodal harvest based on current guidelines. Younger patients
less than 50 years of age and female patients were associated with improved nodal harvest. In this
study, age≥65 years and fixed tumors are more likely to have radial margin involvement.
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Keywords
Adequacy, resection, colorectal cancer, Ethiopia