Main Article Content
Abstract
ABSTRACT
Introduction. Colorectal cancer (CRC) is a public health issue. In Cameroon, its incidence is constantly increasing, hence this study which purpose was to look for prognostic factors. Methods. This was an 11 years prognostic study, from January 1, 2006 to december 31, 2016. The parameters studied were those associated with survival. Survival was based on the date of diagnosis and the date of death or last visit. Survival was presented as a Kaplan Meier curve. The Log Rank test allowed comparison between the different groups. Cox's regression made possible to identify the various associated factors. The significance threshold was 0.05. Results. We collected 270 files representing 28.7% out of a total of 940 participants with digestive cancer. The average age was 50 ± 15.3 years. The sex ratio of 1.3. The median survival rate was 17 months and overall and without progression survival rate at 5 years was 3% and 12.6% respectively. Stages 2, 3 and 4 of the disease were associated with mortality (p<0.005) as well as diagnostic delay greater than 6 months (p= 0.008) and co-morbidities (p= 0.024). Conclusion. Colorectal cancer occurs at a relatively young age in the Cameroonian subject and is associated with a poor prognosis. Prognostic factors are tumor stage, diagnostic delay and co-morbidities.
RÉSUMÉ
Introduction. Le cancer colorectal (CCR) est un problème de santé publique. Au Cameroun, son incidence est en constante augmentation d’où cette étude dont le but était d’en rechercher les facteurs pronostiques. Méthodes. Il s’agissait d’une étude pronostique sur 11 ans, du 1er janvier 2006 au 31 décembre 2016. Les paramètres étudiés étaient ceux associés à la survie. La survie était établie en fonction de la date du diagnostic et de la date du décès ou de la dernière consultation. La survie était présentée sous forme de courbe de Kaplan Meier. Le Test de Log Rank a permis la comparaison entre les différents groupes. La régression de Cox a permis de ressortir les différents facteurs associés. Le seuil de significativité était de 0,05. Résultats. Nous avons colligé 270 dossiers soit 28,7% sur un total de 940 patients avec cancer digestif. L’âge moyen était de 50 ± 15,3ans. Le sex ratio de 1.3. La médiane de survie était de 17 mois et la survie globale et sans progression à 5 ans était respectivement de 3% et 12,60%. Les stades 2,3 et 4 de la maladie étaient associés à la mortalité (p<0.005) tout comme le délai diagnostique supérieur à 6 mois (p= 0,008) et la présence de comorbidités (p= 0,024). Conclusion. Le cancer colorectal survient à un âge relativement jeune chez le sujet camerounais. Il est associé à un pronostic péjoratif. Les facteurs pronostiques étant le stade tumoral, le délai diagnostique et les comorbidités.
Article Details
References
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- Ferlay J, Soerjomataram I, Ervik M. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11.
- Diallo-owono K, Nguema MR, Ibada J, Mihindou C, N’dong F. Epidemiological and Diagnostic Features of Colorectal Cancer in Libreville, Gabon. Medicine Tropical, 2011, 71, 605-607.
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- Takongmo S, Essame-oyono JL, Binam F, Sadou H, Malonga EE. Les cancers colorectaux du sujet de moins de 40 ans à Yaoundé : des particularités anatomo-cliniques. Med d’Afr Noire. 2000; 47(2): 101-104.
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- O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst. 6 oct 2004;96(19):1420‑5.
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- Kube R, Mroczkowski P, Granowski D, Benedix F, Sahm M, Schmidt U, et al. Anastomotic leakage after colon cancer surgery: a predictor of significant morbidity and hospital mortality, and diminished tumour-free survival. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. févr 2010;36(2):120‑4.
References
American Cancer Society. Cancer Facts & Figures 2014. Atlanta: American Cancer Society; 2014.
Ferlay J, Soerjomataram I, Ervik M. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11.
Diallo-owono K, Nguema MR, Ibada J, Mihindou C, N’dong F. Epidemiological and Diagnostic Features of Colorectal Cancer in Libreville, Gabon. Medicine Tropical, 2011, 71, 605-607.
Ndjitoyap N, Mbakop A, Tzeuton C. Les cancers recto-coliques au Cameroun : aspects épidémiologiques et cliniques de 122 cas. Med. Chir. Dig. 1990,19: 427-30.
Sarr A, Isselmou E, Horma B, Diédhiou A. Mbaye N, Sow D et al. Colorectal Cancers in Mauritania: Clinical Aspects and Treatment. Open Journal of Internal Medicine, 2016, 6, 139-146.
Obrocea FL, Sajin M, Marinescu EC, Stoica D. Colorectal cancer and the 7th revision of the TNM staging system: review of changes and suggestions for uniform pathologic reporting. Romanian J Morphol Embryol Rev Roum Morphol Embryol. 2011;52(2):537‑44.
Abou-Zeid AA, Khafagy W, Marzouk DM, Alaa A, Mostafa I, Ela MA. Colorectal cancer in Egypt. Dis Colon Rectum. sept 2002;45(9):1255‑60.
Vuik FE, Nieuwenburg SA, Bardou M, Lansdorp-Vogelaar I, Dinis-Ribeiro M, Bento MJ, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 1 oct 2019;68(10):1820‑6.
Rosato V, Bosetti C, Levi F, Polesel J, Zucchetto A, Negri E, et al. Risk factors for young-onset colorectal cancer. Cancer Causes Control CCC. févr 2013;24(2):335‑41.
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, et al. The Global Burden of Cancer 2013. JAMA Oncol. juill 2015;1(4):505‑27.
Connell LC, Mota JM, Braghiroli MI, Hoff PM. The Rising Incidence of Younger Patients With Colorectal Cancer: Questions About Screening, Biology, and Treatment. Curr Treat Options Oncol. 2017;18(4):23.
White A, Ironmonger L, Steele RJC, Ormiston-Smith N, Crawford C, Seims A. A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK. BMC Cancer . 20 sept 2018;18.
Andoulo FA, Kowo M, Nonga BN, Djapa R, Sartre MT, Njoya O, et al. Indications, résultats et rendement de la coloscopie dans un environnement économique défavorable : le cas du Cameroun. Health Sci Dis. déc 2016;14(4):1‑6.
Kenfack GU, Eloumou SAFB, Nga WTB, Wafeu GS, Tolefac PN, Malongue A, et al. Indications, Yield and Outcome of Colonoscopy: A 7-Year Retrospective Study in a Resource-Limited Setting. Open J Gastroenterol. 10 avr 2019;9(3):49‑58.
Yang J, Du X lin, Li S ting, Wang B yuan, Wu Y ying, Chen Z ling, et al. Characteristics of Differently Located Colorectal Cancers Support Proximal and Distal Classification: A Population-Based Study of 57,847 Patients. PLoS ONE. 9 déc 2016;11(12).
Takongmo S, Essame-oyono JL, Binam F, Sadou H, Malonga EE. Les cancers colorectaux du sujet de moins de 40 ans à Yaoundé : des particularités anatomo-cliniques. Med d’Afr Noire. 2000; 47(2): 101-104.
Burton S, Norman AR, Brown G, Abulafi AM, Swift RI. Predictive poor prognostic factors in colonic carcinoma. Surg Oncol. août 2006;15(2):71‑8.
O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst. 6 oct 2004;96(19):1420‑5.
Ben-Ishay O, Peled Z, Othman A, Brauner E, Kluger Y. Clinical presentation predicts the outcome of patients with colon cancer. World J Gastrointest Surg. 27 avr 2013;5(4):104‑9.
Kube R, Mroczkowski P, Granowski D, Benedix F, Sahm M, Schmidt U, et al. Anastomotic leakage after colon cancer surgery: a predictor of significant morbidity and hospital mortality, and diminished tumour-free survival. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. févr 2010;36(2):120‑4.