Facteurs Pronostiques du Cancer Colorectal au Cameroun

Servais Albert Fiacre Bagnaka Eloumou, Winnie Tatiana Bekolo Nga, Gabin Ulrich Kenfack, Leonce Touko, Agnès Malongue, Christian Tzeuton, Oudou Njoya, Henry Namme Luma, Firmin Ankouane Andoulo, Dominique Noah Noah

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.

Keywords


Survie, facteur pronostic, cancer colorectal, Cameroun

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