AN OVERVIEW OF COLORECTAL CARCINOMA AT ONCOLOGY

DEPARTMENT OF BANGABANDHU SHEIKH MUJIB MEDICAL

UNIVERSITY(BSMMU):2 YEARS EXPERIENCEProf. Sarwar Alam

ChairmanDepartment of oncology,BSMMU.

Prepared by Dr.S.M.Nazmul Alam,Resident,Oncology,BSMMU.

BACKGROUND

• Colorectal carcinoma(CRC) is an important public health problem affecting the caecum,colon & rectum.• There are nearly one million new cases of colorectal cancer diagnosed world wide each year(9.7% of overall cancer) & half a million death(8% of overall death worldwide).

ETIOLOGY

MODIFIABLE RISK FACTOR

DIAGNOSTIC TOOL• Biochemistry-CBC,LFT, CEA ,CA 19-9• Colonoscopy & Biopsy confirmation• Imaging-CXR• CT or MRI with contrast of chest,abdomen & pelvis.• PET scanning

TREATMENT MODALITIES

• Surgery,only universally accepted curative treatment• Adjuvant chemotherapy.•Neoadjuvant therapy for locally advanced rectal carcinoma.• Radiotherapy

CHEMO REGIMEN

• FOLFOX• XELOX•Mayo regimen• IFL• FOLFIRI• FUFOX• IROX•Monoclonal antibodies like Bevacizumab,cetuximab.

BACKGROUND IN BANGLADESH

• As well as in Bangladesh it is one of the emerging cancer among the population.• It is the 8th leading cancer in bangladesh.• In male it ranked 6th and in female it ranked 9th position according to hospital based cancer registry report 2014 by NICRH.

AIM AND OBJECTIVE

• Investigate various epidemiological prevalence like age,sex,family history,personal habit• site of primary cancer,presence of metastasis & stage at presentation as well as the response of treatment.

MATERIAL AND METHOD

• Study type- retrospective study• Study population- 200 Patients • Study period - December 2014 to December 2016.• Research data form containg detailed history, clinical examinations, staging,previous treatment, present treatment plan and follow up records were evaluated.

OBSERVATION AND RESULT

RESULT

• AGE-Mean age of patients at diagnosis was 47 years with a range from 25 to 70 years.•GENDER-63% were male and 37 % were female.• TOBACCO-53% patients were smoker.• 23% patients had positive family history.

AGE AT PRESENTATION

25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-above0

10

20

30

40

50

60

712

17 16

51

22 21 24 22

8

No.of patient

Age of the patient

GENDER DISTRIBUTION

25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-above

0

5

10

15

20

25

30

35

malefemale

male female

Age of the patient

No.of patient

PRESENTATION

56

4243

20

246 abdominal pain

altered bowel habitbleeding weaknessanemia & othersweight loss

number of presentation as per symptoms

ANATOMICAL DISTRIBUTION

46%

20%

16%

9%

Ascending colon Rectum sigmoid colon transverse and desce3nding

MORPHOLOGICAL TYPE OF CARCINOMA

97%

3%

adenocarcinomalymphoma

STAGE AT TIME OF DIAGNOSIS

stage 2 stage 3 stage 40

10

20

30

40

50

60

70

80

23

68

9

stage

ACCORDING TO OPERABILITY

operableinoperable

TREATMENT

60%

35 %

5 %

XELOX FOLFOX Mayo regim

CHEMOCARD

COLONOSCOPY REPORT

CONCLUSION

• Colorectal cancer is a common form of malignancy with identifiable risk factors.• Treatment can improve overall survival,especially when the disease is diagnosed at an early stage.

CONCLUSION

CRC is a disease that requires multidisciplinary teamwork.A well defined guideline for screening,biopsies,surgical and medical management is important to screen appropriate patients,reduce its incidence and care for those affected by this disease

THANK YOU ALL