AN OVERVIEW OF COLORECTAL CARCINOMA AT ONCOLOGY DEPARTMENT OF BANGABANDHU SHEIKH MUJIB MEDICAL UNIVERSITY(BSMMU):2 YEARS EXPERIENCE Prof. Sarwar Alam Chairman Department of oncology,BSMMU. Prepared by Dr.S.M.Nazmul Alam,Resident, Oncology,BSMMU.
Apr 11, 2017
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