Assessment of Survival Outcomes of Histopatho-Logical Subtypes of Colorectal Adenocarcinoma in Ugandan Patients | Chapter 19 | New Horizons in Medicine and Medical Research Vol. 3

 High-grade mucinous adenocarcinomas are more common in younger people in the West and are associated with a poor prognosis. In Uganda, the survival outcomes of distinct colorectal adenocarcinoma (CRC) and lymphovascular invasion (LVI) histopathologic subtypes remain unknown. In Ugandan patients, we looked at the survival rates of several histopathologic subtypes of CRC and LVI.

Methods: A retrospective cohort analysis on individuals diagnosed with CRC from 2008 to 2018 was conducted using the Kampala Cancer Registry and hospital medical data. The date of diagnosis, demographics, stage, grade, and location of the CRC were all acquired. Histopathologic subtype, stage, grade, and LVI were the key predictive variables for our result. To evaluate factors related with survival, we utilised Kaplan-Meier survival curves, log-rank tests to test survival equality, and multivariable Cox regression to determine factors associated with survival.

Mucinous adenocarcinoma/signet ring colorectal carcinoma (MAC/SRCC) was found in 12.4% of patients, while classical adenocarcinoma was found in 87.6%. (AC). The median age (SD) at diagnosis for MAC/SRCC was 47.8 (16.6) years, while the median age (SD) for AC was 53.8 (15.9) years. SRCC/MAC was related with considerably greater LVI than AC (p=0.002). Stage III (aHR=2.56; p=0.009) and stage IV (aHR=6.64; p=0.001) were found to be significantly related with increased mortality in multivariate analysis. SRCC/MAC patients had a shorter survival than AC patients after correcting for lymph node involvement and metastasis; however, this difference was not statistically significant (p=0.229).

Conclusions: Uganda's MAC share is comparable to that of the Western world. LVI was shown to be more closely linked to SRCC/MAC than AC. Patients with SRCC/MAC had a worse overall survival rate. Because more individuals in Uganda are diagnosed with advanced-stage CRC, which is linked to a poor prognosis, national screening recommendations are needed to increase survival rates.


Author(S) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Julius Kiwanuka
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Henry Wabinga
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Michael Odida
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

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