Colorectal cancer patient outcomes in Nigeria: Results from the African Colorectal Cancer Group

Autor: Anne Eaton, Akinwunmi O. Komolafe, Olaejinrinde O. Olaofe, Olusegun I. Alatise, Olufemi O Ariyibi, Oladapo Adedayo Kolawole, Aba Katung, O C Famurewa, SA Olatoke, T. Peter Kingham, Adedeji A Egberoungbe, Olayide Agodirin
Rok vydání: 2016
Předmět:
Zdroj: Journal of Clinical Oncology. 34:729-729
ISSN: 1527-7755
0732-183X
Popis: 729 Background: Colorectal cancer (CRC) is a growing problem in sub-Saharan Africa. There are, however, limited data describing the demographics, risk factors, presentation, treatments, and outcome of patients with CRC there. We established the African Colorectal Cancer Group (ARGO) to prospectively capture data and tissue from patients with CRC in Nigeria. This is vital to guide screening and treatment trials. Methods: The Consortium consists of 5 hospitals in Nigeria and MSKCC (USA). We have been prospectively collecting data since 2013. Tissue and blood samples were obtained. Ultrasounds and CT scans were provided by an NCI grant. Overall survival from date of diagnosis was estimated using Kaplan-Meier methods. Results: 152 patients have been accrued. The majority was male (56.8%), the median BMI was 22, the majority were non-smokers (89.1%) and non-drinkers (73.5%). Many patients had symptoms, as 65.8% of patients presented with obstruction or bleeding, 52.1% of patients had pellet like stool, and 88.4% had weight loss. 33.3% saw a traditional healer prior to presentation. The common locations of the primary tumor were rectum (52%) and right colon (23%). 8 patients (6.4%) had CEA > 30 ng/mL. The majority of patients presented with advanced disease. 43 (32.3%) patients had T3 tumors; 87 patients (66.9%) had T4 tumors. AJCC stage was II (n = 12, 9.3%), III (n = 34, 26.4%), and IV (n = 83, 64.3%). 97 patients (66%) had surgery. The most common operations were right hemicolectomy (23.1%) and diverting colostomy (22.4%). 110 patients (88.7%) had chemotherapy recommended; only 71 patients (61.2%) received chemotherapy. The reasons for not receiving chemotherapy included patient finances (n = 19) and mortality (n = 12). The commonly utilized chemotherapies were FOLFOX (n = 24) and XELOX (n = 15). 62 patients died with a median follow-up among survivors of 4.4 months. Overall 12-month survival from date of diagnosis (N = 138), was 48.4% (95% confidence interval 38.9-60.1). Conclusions: The majority of patients that present to hospitals in Nigeria with CRC are stage IV. The mortality rate is high. These data serve as a baseline to judge current screening trials. Identifying high-risk patients for screening is vital to improve outcomes.
Databáze: OpenAIRE
Externí odkaz: