COLORECTAL CANCER: OUR EXPERIENCE AT A SINGLE TERTIARY CARE CENTER

Abstract

Background: Colorectal cancer (CRC) is among the most common gastrointestinal malignancies worldwide, and recent reports describe a rising burden in South Asia, including Pakistan. Robust local outcome data from tertiary centres remain limited.

Objective: To evaluate the clinical characteristics, management, and short-term postoperative outcomes of patients with primary CRC treated at a tertiary care centre.

Methods: This descriptive study was conducted in the Department of General Surgery, Hayatabad Medical Complex, Peshawar, over six months following ethical approval. A total of 138 consecutive patients with histopathologically proven primary CRC were enrolled by non-probability convenience sampling. Demographic data, clinical characteristics (presenting symptoms, tumour site, stage, histology), management, and postoperative outcomes (surgical site infection, anastomotic leak, recovery at three months, length of hospital stay) were recorded on a structured questionnaire. Data were analysed using SPSS version 16. Quantitative variables were expressed as mean ± SD and categorical variables as frequencies and percentages. Chi-square test was applied for effect modifiers with a p-value < 0.05 considered statistically significant.

Results: The mean age was 58.7 ± 7.8 years, with a slight female predominance (51.4%). The rectum was the most common tumour site (37.7%), and Stage III disease predominated (62.3%). Right hemicolectomy was the most frequently performed procedure (47.8%), followed by low anterior resection (LAR, 25.4%). The overall surgical site infection rate was 24.6%, anastomotic leak rate was 8.7%, and 87.0% of patients achieved complete recovery at three months. The mean length of hospital stay was 4.7 ± 2.5 days. Surgery type was significantly associated with anastomotic leak (p < 0.001), recovery (p = 0.013), and length of stay (p < 0.001); LAR for rectal cancer showed the highest leak rate (28.6%) and longest mean stay (6.7 days).

Conclusion: In our cohort, CRC presented at a relatively younger age than in Western series and was predominantly locally advanced. Postoperative morbidity was concentrated in patients undergoing LAR for rectal cancer, underscoring the need for meticulous patient selection, anastomotic technique, and perioperative care in this subgroup, and supporting structured CRC screening in the region.