A PROSPECTIVE OBSERVATIONAL STUDY OF MANAGEMENT PROTOCOL OF LOCALLY ADVANCED CARCINOMA RECTUM AT MGMMC AND MY HOSPITAL, INDORE

Abstract

BACKGROUND Before 1900, Colon and Rectal cancer incidence was negligible. Following economic development and industrialisation, the incidence of colorectal cancer has been rising dramatically. The vast majority (98%) of colon and rectal cancers comprises of Adenocarcinomas. Other rare rectal cancers included carcinoid (0.4%), lymphoma (1.3%) and sarcoma (0.3%). Squamous cell carcinomas may develop in the transition area from the rectum to the anal verge and are considered anal carcinomas. Very rare cases of squamous cell carcinoma of the rectum have been reported. Approximately, 20% of colon cancers develop in the cecum. MATERIALS AND METHODS This is a prospective study of all patients with locally advanced carcinoma rectum seen at MY and Cancer Hospital, Indore. Between January 2011 and October 2012, 45 patients with rectal cancer were seen at MY and Cancer Hospital, Indore. Their age range was 20 - 75 years. The male/female ratio was 1.3: 1. Fisher's exact test was applied for statistical analysis. RESULTS 15 had abdominoperineal (AP) resection, 10 had anterior resection and 20 had tumours that were not resectable. 9 of the 15 patients (60%) who had AP resection are alive till date, 6 died, while 10 out of the 10 who had anterior resection (100%) are alive till date. CONCLUSION Patients with advanced rectal cancer should receive postoperative chemoradiotherapy. Local control, distant spread and survival improves when postoperative radiation therapy is combined with chemotherapy.