Analysis of risk factors, treatment patterns, and survival outcomes after emergency presentation with colorectal cancer: A prospective multicenter cohort study in Nigeria Journal Article
| Authors: | Aderibigbe, A. S.; Dare, A. J.; Kalvin, H. L.; Olasehinde, O.; Wuraola, F.; Adisa, A.; Omisore, A. D.; Komolafe, A. O.; Omoyiola, O. Z.; Okereke, C. E.; Katung, A.; Egberoungbe, A.; Ariyibi, O.; Olatoke, S. A.; Adeyeye, A. A.; Agodirin, S. O.; Bojuwoye, M. O.; Fayenuwo, J. O.; Ademakinwa, O. R.; Osinowo, D.; Lawal, A. R.; Abdulkareem, F. B.; Goldman, D.; Knapp, G.; Murthy, S.; Kahn, R.; Gonen, M.; Kingham, T. P.; Alatise, O. I.; For the African Research Group in Oncology Colorectal Cancer Working Group |
| Article Title: | Analysis of risk factors, treatment patterns, and survival outcomes after emergency presentation with colorectal cancer: A prospective multicenter cohort study in Nigeria |
| Abstract: | Background and Objectives: Prospective data on presentation and outcomes of colorectal cancer (CRC) in Nigeria are limited; however, emergency presentation with advanced disease is thought common. Methods: Consecutive CRC patients presenting at six sites over 6 years were included. Risk factors for emergency presentation were evaluated using logistic regression methods. Overall survival (OS) was compared between emergent and elective patients using Kaplan-Meier methods and the log-rank test. Results: Of 535 patients, 30.7% presented emergently. Median age was 56 years, 55% were men, and 5.0% reported a cancer family history. Emergency patients had more proximal cancers (42.1% vs. 24.0%), Stage IV disease (61.6% vs. 40.2%; p < 0.001), lower household income (₦35 000/month vs. ₦50 000/month), lower education levels (p = 0.008) and accessed care with nonmotorized transport (50.6% vs. 37.2%; p = 0.005). Median OS was shorter in the emergency group (6.4 vs. 17.4 months; p < 0.001). Across clinical stages, emergency presentation was associated with worse OS (Stage IV median OS 4.8 vs. 9.4 months; p = 0.002). Surgery improved survival in both groups, although emergency patients had higher 30-day postoperative mortality (23.2% vs. 9.1%; p < 0.001). Conclusions: Emergent Nigerian CRC patients have worse OS than elective patients. Cancer control efforts should focus on faster cancer detection, early presentation, diagnosis, and treatment. © 2024 Wiley Periodicals LLC. |
| Keywords: | adult; cancer survival; controlled study; aged; middle aged; survival analysis; survival rate; major clinical study; overall survival; clinical trial; mortality; fluorouracil; comparative study; cancer staging; outcome assessment; follow up; follow-up studies; antineoplastic agent; prospective study; prospective studies; colorectal cancer; treatment indication; imatinib; cohort analysis; risk factors; pathology; risk factor; risk assessment; colorectal neoplasms; multicenter study; colorectal tumor; folinic acid; family history; clinical evaluation; surgical mortality; emergency care; kaplan meier method; cancer control; epidemiology; educational status; logistic regression analysis; therapy; health care access; patient transport; nigeria; emergency; procedures; cancer family; emergencies; west africa; capecitabine plus oxaliplatin; humans; prognosis; human; male; female; article; middle income country; emergency patient; household income; emergency presentation; low- and middle-income countries (lmics) |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 131 |
| Issue: | 2 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2025-02-01 |
| Start Page: | 170 |
| End Page: | 182 |
| Language: | English |
| DOI: | 10.1002/jso.27878 |
| PUBMED: | 39574208 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: T. Peter Kingham -- Source: Scopus |
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