Colorectal Cancer Patients in a Tertiary Referral Centre in Malaysia: a Five Year Follow-up Review

Background: Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC isfast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental andgenetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Materialsand
Methods: Retrospective case review study done on CRC patients at Universiti Kebangsaan Malaysia MedicalCentre (UKMMC), Kuala Lumpur, Malaysia. Patients’ socio-demographic characteristics, modalities oftreatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records.
Results:A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%).Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms includingper rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presentedwith Dukes C stage(40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%.Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lowerrecurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinesepatients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment(22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45).
Conclusion: Socio-demographicprofile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatmentgives rise to poor overall survival and local recurrence rates.