Clinical profile and factors affecting surgical outcome of colorectal carcinoma in rural India: a study of 60 cases


  • Lalit Vishvanath Tamgadge Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Mohd Hamid Shafique Ahmed Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Subodh Prabhakar Ugane Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Prakash Dattatray Gurav Department of General Surgery, Government Medical College, Miraj, Maharashtra, India



Abdomino-perineal resection, Colorectal carcinoma, Colectomy, Histopathology


Background: Colorectal carcinoma is the most common of the gastrointestinal tract malignancy. Aim of our study is to look for the clinical profile and factors affecting the surgical outcome of colorectal malignancy in rural India.

Methods: In this study, 60 patients, whose surgery and follow up was performed by same correspondent Surgeons between years Nov 2011 to Oct 2013, were prospectively analyzed.

Results: Of the 60 cases analyzed, we encountered the highest number of cases in the sixth and seventh decade in both sexes with male to female ratio 1:1. Alternating bowel habits, bleeding per rectum, giddiness and anorexia, weight loss, pain in abdomen were the most common presenting complaints with mean duration of symptoms was 6 months before diagnosis. Rectum and recto-sigmoid was the commonest site for occurrence of large bowel cancer (56.66%).  Duke’s system of staging with Turnbull et al modification shows majority of cases (50.00%) in category C. Well differentiated adenocarcinoma is the commonest histological pattern noted in more than half of cases. Post-operative recurrence was detected in 16.67% of cases with 33.33% of cases have not had a detectable recurrence to date.

Conclusions: Rectum being the commonest site for occurrence of colorectal malignancy, diet and other predisposing factors could not be implicated in the occurrence. Age, weight loss, emergency admission, operation type, advanced stage of disease at presentation, loss of regular follow-up and lower socio-economic status of patients of rural India significantly affect the outcome of surgery.


GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide, version 1.0 IARC. Cancer. Lyon, France: IARC press. 2001.

Obrand DI, Gordon PH. Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum. 1997;40:15-24.

Colon and rectum. In: American Joint Committee on Cancer. AJCC Cancer staging manual. 5th ed. Philadelphia: Lippincott Raven. 1997:83-90.

Rise LAG, Eisner MP, Kosary CL. SEER Cancer statistics review 1973-1988. Bethesda, Md: National Cancer Institute, 2001.

Joshi K J: The Intestinal tract, in surgical disease in the tropics, 1st ed (Reprint) Madras; Mac Millan. 1982:282-4.

Holiday HW, Hard JD. Delay in diagnosis and treatment of colorectal cancer. Lancet. 1979;1:3096-311.

Jarvinen HJ, Ovaska J, Mecklin JP. Improvements in the treatment and prognosis of colorectal carcinoma. Br J Surg. 1988;75:25-7.

Homji DR, Gangadharan P. Malignant neoplasms of the lower alimentary tract. J Indian Med Assoc. 1972;59(7):271-5.

Dukes CE, Bussey HJR. Importance of age and sex in colorectal carcinoma: Br J Cancer. 1958;12(3):309-20.

Choudhary M, Reys N. Some observations on carcinoma of the large bowel with special reference to pathological findings. Indian J Surg. 1963;25:134-44.

Levin KE, Dozois RR: Epidemiology of large bowel cancer. World J Surg. 1991;15:562-7.

Ssali JC. Carcinoma of the large bowel in Uganda. Ann R Coll Surg Engl. 1977;59(5):420-2.

Muir EG. The diagnosis of carcinoma of the colon and rectum: a review of 714 cases. Br J Surg. 1956;44(183):1-7.

Goligher JC, Smiddy FG. The treatment of acute obstruction or perforation with carcinoma of colon and rectum. Br J Surg. 1957:270.

Corman ML. Carcinoma of the colon. In colon and rectal surgery 2nd Edition, Philadelphia: JB Lippincott. 1989:287-468.

Cady B, Person AV, Manson DO, Manuz DL. Changing patterns of colorectal carcinoma. Cancer. 1974;33:422-6.

Kodner IJ, Fry RD, Fleshman JW, Birnbaum EG, Read TE. Colon, rectum and anus. In Principles of Surgery, 7th edition, Schwartz SI, New York, McGraw Hill. 1999:1265-382.

Goligher JC. Clinical features, diagnosis and treatment of the carcinoma colon and rectum. In surgery of the anus, rectum and colon, 5th edition. Goligher JC London: Baillere Tindall. 1984:465-84,590-770.

Staniunas RJ, Schoetz DJ. Extended resection for carcinoma of colon and rectum. Surg Clin North Am. 1993;73:117-29.

Shah A, Wani NA. A study of colorectal adenocarcinoma. Ind J Gastroenterol. 1991;10(1):12-3.

Goligher JC: Incidence and pathology of carcinoma of the colon and rectum. In surgery of anus, rectum and colon, 5th Ed., ed. Goligher JC, London: Bailliere Tindall. 1984:426-464.

Brown SCW, Walsh S, Sykes PA. Operative mortality rate and surgery for colorectal cancer. Br J Surg. 1988;75:645-7.

Metzger U. Adjuvant therapy for colorectal carcinoma. World J Surg. 1991;15(5):576-82.

Jones PF, Thomson HJ; Long term result of a consistent policy of sphincter preservation in the treatment of carcinoma of the rectum. Br J Surg. 1982;69(10):564-8.

Fazio VW, Tjandra JJ. Primary therapy of carcinoma of the large bowel. World J Surg. 1991;15:568-75.






Original Research Articles