Clinical Outcomes of Colorectal Cancer in Kenya
Authors: Saidi H1,2 MBChB, MMed, FACS, Abdihakin M2 MBChB, Njihia B1 Bsc, Jumba G1 Phd, Kiarie G 1 MMed, Githaiga J1 MMed, Abinya
NO1,2 MMed. Affiliations: 1-University of Nairobi and Kenyatta National Hospital 2-Aga Khan University Hospital, Nairobi Correspondence: Prof. Hassan Saidi, Dept of Human Anatomy, University of Nairobi. P.O. Box 30197, GPO 00100, Nairobi, Kenya. E-mail
The incidence of colorectal cancer in Africa is increasing. True data on clinical outcomes of the disease is hampered by follow up challenges.
Follow up data of 233 patients treated for colorectal cancer between 2005 and 2010 at various Nairobi hospitals were evaluated. The primary outcome was mortality while secondary outcomes included recurrence rates, time to recurrence and the patient, disease and treat-ment factors associated with mortality and recurrence. Kaplan Meir charts were charted for survival trends.
Half of the lesions were located in the rectum. There was no relation-ship between the sub-site location and recurrence and mortality.
The mean follow-up period was 15.9 months. Overall recurrence and mortality rates were 37.5% and 29.4% respectively. Most recurrences occurred within one year of surgery. Recurrence was not influenced by age, gender, sub-site, chemotherapy receipt or presence of co-morbidity. Factors significantly associated with mortality included the male gender ( p 0.04), presence of co-morbidity (p 0.029), recurrence (p 0.001), curative intent (p 0.01), disease stage (p 0.036) and receipt of chemotherapy ( p< 0.01).
Follow up of colorectal cancer patients is still challenging. The mortal-ity and recurrence rates are high for the short follow up periods. Fur-ther studies are needed to explore the determinants of both survival and recurrences, especially with longer follow ups.