Clinicopathological features and short-term surgical outcomes of early-onset versus late-onset colorectal cancer at a tertiary hospital in Tanzania: A retrospective-cohort study

Abstract

Background

Despite the reported rising trend of early-onset CRC incidence globally, little is known about the clinical profile and primary CRC surgical outcome in Tanzania and sub-Saharan Africa. This study aimed to analyze the clinicopathological features and short-term surgical outcomes of early-onset CRC patients undergoing primary surgery.

Methodology

The patients who underwent primary CRC surgery and whose diagnosis was confirmed by histopathology were identified and reviewed from prospectively maintained medical records. Clinicopathological characteristics and short-term surgical outcomes were analyzed and compared between groups.

Results

A total of 225 patients were included in this study, there were 137 patients in the late-onset CRC group and 88 in the early-onset group. After a 1:1 ratio PSM, there were 86 patients in each group. The overall proportion of early-onset CRC patients was 39.1 %. With regards to baseline characteristics of gender, tumor stage, tumor location, and presenting symptoms, there was no significant difference between early-onset and late-onset CRC patient groups before and after propensity score Matching (PSM) analysis (p > 0.05). After PSM, Early-onset CRC patients had a significantly higher proportion of Signet-ring cell histology (p = 0.007) and a higher rate of overall postoperative complications, (p = 0.043). The multivariate analyses showed that early-onset CRC patients (p = 0.048, OR=2.14, 95 % CI=1.01–4.53) and emergency surgery (p = 0.011, OR=2.79, 95 % CI=1.27–6.13) were significant predictors of overall postoperative complications

Conclusion

Early-onset CRC patients showed a significantly higher proportion of Signet-ring cell histology (poorly differentiated) and overall short-term postoperative complications. The early-onset CRC patients and emergency surgery were significant predictors of overall short-term postoperative complications