Clinicopathological features of Complicated Colorectal  Cancers: A 10 Year Retrospective Study in Egypt

Radwan Abdelsabour Torky; Farghaly RM; Ahmed M. Hussein; Asmaa A. Abdeltawab

doi:10.31557/apjcc.2025.10.3.749-757

Authors

Radwan Abdelsabour Torky Assistant Professor of General and Colorectal Surgery, Colorectal Surgery Unit, Department of General Surgery, Assiut University, Assiut, Egypt. https://orcid.org/0000-0001-9907-6133
Farghaly RM Lecturer of Medical Oncology, Department of Medical Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Ahmed M. Hussein Assistant Lecturer of General Surgery, Assiut University, Assiut, Egypt.
Asmaa A. Abdeltawab Lecturer of Clinical Oncology, Department of Clinical Oncology, Assiut University, Assiut, Egypt.

DOI:

https://doi.org/10.31557/apjcc.2025.10.3.749-757

Keywords:

CRC, complications, emergency, metastases

Abstract

Purpose: The prognosis for emergency surgery for colorectal cancers (CRCs) and metastatic tumors was reported to be extremely poor. Our objective is to ascertain the clinical characteristics of patients who have been diagnosed with complications and metastases at two tertiary centers in Egypt.

Methods: a comparative retrospective study between complicated and non-complicated CRCs conducted in two tertiary centers in Egypt over 10 years.

Results: a total of 320 patients underwent surgery for CRC, of which 25% underwent emergency surgery (80 cases) and 240 (75%) patients underwent an elective one. There was a higher rate of complicated colon and non-complicated rectal cancer (P=0.009). There was a significantly higher rate of positive L.Ns, positive LVI and PNI (P = 0.001), (P <0.001) and (P <0.001) respectively in complicated group. In multivariate analysis, only the tumor site (right colon P= 0.010, left colon P= 0.022) as well as the LVI (P= 0.038) remained the most important predicting factors for complication. There was a significantly higher rate of OS in patients with T1 and T2 (P= 0.002), in patients with grade I and II (P= 0.005), node-negative and non-metastatic disease with (P=<0.001) and (P= <0.001) respectively.

Conclusion: Right and left colon cancers, along with positive LVI, are regarded as risk factors for emergency complications and metastases meanwhile advanced stages, unfavorable grades, and node-positive tumors, are associated with a poor prognosis in both groups.