RETROSPECTIVE ANALYSIS OF EPIDEMIOLOGY, PROGNOSTIC FACTORS AND RESPONSE OF TREATMENT OF RECTAL CANCER

Abstract

R ectal cancers have always been considered as a part of CRCs in related epidemiological studies, it’s one of the major public health problems. Rectal cancers are the second most common (28%) cancers in large intestine after proximal colon cancers (42%). Colorectal cancer is the 7th commonest cancer in Egypt, representing 3.47% of male cancers and 3% of female cancers. Colorectal cancers vary in terms of risk factors and clinical and biological characteristics based on their location within the colon or rectum, suggesting distinct etiologies and carcinogenic mechanisms. The most common tumor location is the proximal colon (42%), followed by the rectum (28%). However, the sub site distribution varies by sex. Compared with men, women have a higher percentage of proximal tumors (46% vs 38%) and a lower percentage of rectal tumors (24% vs 31%). There are also differences in sub site distribution by age at diagnosis, with a notable increase in proximal tumors and decrease in rectal tumors with advancing age. Environmental and genetic factors can increase the likelihood of developing CRC. The individual risk of colorectal cancer is essentially dependent on risk factors such as age, sex, and family history. It is estimated that 30–50% of the colorectal cancer risk is attributable to lifestyle factors such as smoking, high consumption of red and processed meat, obesity, diabetes, and excessive consumption of alcohol. Surgery is the cornerstone of curative therapy for rectal adenocarcinoma. Depending upon the clinical stage, size, and location of the primary tumor, a rectal cancer can be treated with either local or radical excision. Among patients receiving neoadjuvant treatment for rectal cancer, the posttreatment stage (given ayp designation in the AJCC staging system) is a more accurate predictor of outcome than the pretreatment clinical stage. Our study aimed to evaluate the clinico-epidemiological factors and response to treatment in rectal cancer patients and correlate them to disease free and overall survival outcome. The most powerful tool for assessing prognosis following potentially curative surgery for rectal cancer is pathologic analysis of the resected specimen. The most important clinico-pathological characteristics are the presence of distant metastases, local tumor extent, nodal positivity, circumferential resection margin invasion, lymphovascular and perineural invasion and histologic grade of differentiation.