Clinical outcomes of colorectal cancer in Kenya

Abstract

Background The incidence of colorectal cancer in Africa is increasing. True data on clinical outcomes of the disease is hampered by follow up challenges. Method Follow up data of 233 patients treated for colorectal cancer between 2005 and 2010 at various Nairobi hospitals were evaluated. The primary outcome was mortality while secondary outcomes included recurrence rates, time to recurrence and the patient, disease and treatment factors associated with mortality and recurrence. Kaplan Meir charts were charted for survival trends. Results Half of the lesions were located in the rectum. There was no relationship between the sub-site location and recurrence and mortality. The mean follow-up period was 15.9 months. Overall recurrence and mortality rates were 37.5% and 29.4% respectively. Most recurrences occurred within one year of surgery. Recurrence was not influenced by age, gender, sub-site, chemotherapy receipt or presence of comorbidity. Factors significantly associated with mortality included the male gender ( p 0.04), presence of co-morbidity (p 0.029), recurrence (p 0.001), curative intent (p 0.01), disease stage (p 0.036) and receipt of chemotherapy ( p< 0.01). Conclusion Follow up of colorectal cancer patients is still challenging. The mortality and recurrence rates are high for the short follow up periods. Further studies are needed to explore the determinants of both survival and recurrences, especially with longer follow ups.