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(052). Epidemiological aspects of anal cancer: About a Moroccan hospital department experience
Colorectal Cancer / Arab Journal of Gastroenterology 10 (2009) AB27–AB35
The aim of our study is to provide an overview of the major epidemiological characteristics of colon cancer in a Moroccan surgical unit and to discuss the possibility of screening in our practice. Patients and methods: Through a retrospective study from January 2001 to December 2008, we determined the epidemiological characteristics of the 138 colon cancer collected in our unit. Results: Our serie included 81 men (59%) and 57 women (41%). The sex ratio was 1.4. Mean age was 55 ± 16 years (range from 20 to 89). A history of familial polyposes adenoma was found in 4 cases and HNPCC in 4 cases. The mean diagnostic time was 8.5 months. 41% had gastrointestinal hemorrhage and 70% had abdominal mass in clinical examination. The tumor was localized at right colon, transverse colon, left colon and sigmoid respectively in 35.5%, 6.5%, 11% and 45% cases. The pathological anatomy showed adenocarcinoma in 80% cases. Patients (32%) presented advanced stages and metastatic extension was observed in 24.4% cases with 13% liver metastasis, 10% peritoneal carcinomatosis and 1.4% lung metastasis. The operability rate was 82% and the mean survival time 11 months (range 1–60 months). Conclusion: The comparison between our present results and those western series shows some modification,our patients being younger, the cancer frequency in young people higher, time needed for diagnosis longer and the most frequent location occurring in sigmoid. doi:10.1016/j.ajg.2009.07.176
(051) Epidemiologic characteristics of rectal cancers: About 232 cases in a Moroccan hospital unit H. Elmernissi, A. Hrora, K. Mrini, A. Benamer, M. Raiss, F. Sebbah, M. Ahallat Surgical Department, ‘‘C’’ Pr Tounssi A, CHU IBN SINA, Rabat, Morocco
Background: Colorectal carcinoma is the most common gastrointestinal tract cancer worldwide. The prognostic could better by an earlier diagnostic and a multidisciplinary treatment. Aim: The aim of this study was to determine the epidemiological profile, clinical characteristics of the rectal carcinoma in a Moroccan hospital service, and to discuss the possibility of screening in our practice. Methods: We retrospectively studied 232 cases of rectal cancer collected between January 2000 to December 2008, at Surgical Department, ‘‘C’’ CHU IBN SINA, in Rabat ‘‘Morocco’’. Results: 232 patients were managed during the study period with an average of 30 cases per year. The mean age of patients was 52.8 ± 15.4 years with 25.9% patients below 40 years of age. There were 40% females and 60% males. A history of familial polyposis adenoma was found in 3 cases, HNPCC in 6 cases and inflammatory bowel disease in 2 cases. The mean diagnostic delay was 9 months and most common revealing symptoms were rectal bleeding (80%). Lower rectum was involved in 43.5%. Patients (51%) presented at advanced stages with 21% lymph node metasteses and 13% liver metastases diagnosed in CT scan. The histology showed: adenocarcinoma well-differentiated in 63.1%, moderately-differentiated in 20.2%, poorly- differentiated in 2%, colloidal adenocarcinoma in 16.4%, isolated cells in 3%. The radiotherapy preceded the surgery in 46% of cases and associated at the chemotherapy in 7.6%. The operability rate was 75.4% and resecability rate was of 71.9%. Relapse occurred in 9.1%: Local in 47.6% and metastasis in 52.4% (liver: 14.3%, lung: 9.5%, brain: 9.5%, ovary and peritoneum in 4.8%). At five years, the survival was: 34%.
AB28
Conclusion: There is a need to increase awareness through public education about this malignancy and its management. Any adult with blood in the stool or features of haemorrhoids should be adequately investigated with digital rectal examination and colonoscopy. doi:10.1016/j.ajg.2009.07.177
(052) Epidemiological aspects of anal cancer: About a Moroccan hospital department experience H. El Mernissi, L. Ouazzani, I. Errabih, H. Krami, N. Benzzoubeir, H. Ouazzani Hepato-Gastroenterology Unit ‘‘B’’, University Hospital, Ibn Sina, Rabat, Morocco
Background: Anal cancer is rare, representing 1–2% of gastrointestinal cancers and 6% of colorectal cancers, affecting mostly women of 60ans, the initial symptoms are poor. This is a squamous cell carcinoma in 95% of cases. The locoregional evolution is slow. Aim: The aim of our study is to determine epidemiologic characteristics, investigate important risk factors associated with anal cancer in a Moroccan population and compare our data with international publications. Methods: The study was carried out in the medical service ‘‘Medicine B’’. All anal cancer patients diagnosed during the period from January 2000 to December 2007 were included in the study. Results: 20 cases of anal cancer were found during this period, representing 0, 22% of total hospitalizations, 2.4% of all digestive cancer and 7.5% of colorectal cancers. The mean age was 60 years (range 33–87 years), male to female ratio was 4 (4H/1F). Clinical symptommatology has been dominated by anal pain (80%), rectal bleeding (60%). At endoscopy examination, 65% presented as vegetante lesion and 35% as ulceration. 90% of our patients had squamous cell carcinoma and too had melanoma. Hepatic metastasis was found in 15%. Stage of disease was T2N0 in 85%, T3N2 in 15%. Our patients had radiotherapy exclusively in 75%, radio chemotherapy in 15%, surgery and radiochemistry for patient with melanoma (10%). Conclusion: Anal cancer is rare; it is mostly a squamous cell carcinoma. Treatment is mainly based on radiotherapy. The prognosis depends on early diagnosis and treatment. doi:10.1016/j.ajg.2009.07.178
(053) Did the epidemiological profile and the management of rectal cancer changed? G. Drissi, M. Allaoui, M. Chaourak, M. Faik, M. Raiss, F. Sebbah, A. Benamer, A. Hrora, M. Ahllat Surgical C Clinic, Pr A Tounsi, Ibn Sina Hospital, Morocco
Background: The aim of this study was to compare it epidemiological profiles and the management of rectal cancer between two series collected to 13 years of interval. Methods: It is about two retrospective cases, the first one, collected from 1981 to 1985 (series A), includes 80 patients. The second one, recent, collected from 1998 to 2002 (series R), includes 94 patients. We analyzed for the epidemiological profile, the middle number of case per year, age, sex, seat of the tumor, histological type, metastatic stage. We analyzed for the management: operability rate, resection rate, type of intervention. Results: The middle number of cancer of the rectum hospitalized per year in our formation is respectively 16 ± 4.06 and 18 ± 4.14 in
The aim of our study is to provide an overview of the major epidemiological characteristics of colon cancer in a Moroccan surgical unit and to discuss the possibility of screening in our practice. Patients and methods: Through a retrospective study from January 2001 to December 2008, we determined the epidemiological characteristics of the 138 colon cancer collected in our unit. Results: Our serie included 81 men (59%) and 57 women (41%). The sex ratio was 1.4. Mean age was 55 ± 16 years (range from 20 to 89). A history of familial polyposes adenoma was found in 4 cases and HNPCC in 4 cases. The mean diagnostic time was 8.5 months. 41% had gastrointestinal hemorrhage and 70% had abdominal mass in clinical examination. The tumor was localized at right colon, transverse colon, left colon and sigmoid respectively in 35.5%, 6.5%, 11% and 45% cases. The pathological anatomy showed adenocarcinoma in 80% cases. Patients (32%) presented advanced stages and metastatic extension was observed in 24.4% cases with 13% liver metastasis, 10% peritoneal carcinomatosis and 1.4% lung metastasis. The operability rate was 82% and the mean survival time 11 months (range 1–60 months). Conclusion: The comparison between our present results and those western series shows some modification,our patients being younger, the cancer frequency in young people higher, time needed for diagnosis longer and the most frequent location occurring in sigmoid. doi:10.1016/j.ajg.2009.07.176
(051) Epidemiologic characteristics of rectal cancers: About 232 cases in a Moroccan hospital unit H. Elmernissi, A. Hrora, K. Mrini, A. Benamer, M. Raiss, F. Sebbah, M. Ahallat Surgical Department, ‘‘C’’ Pr Tounssi A, CHU IBN SINA, Rabat, Morocco
Background: Colorectal carcinoma is the most common gastrointestinal tract cancer worldwide. The prognostic could better by an earlier diagnostic and a multidisciplinary treatment. Aim: The aim of this study was to determine the epidemiological profile, clinical characteristics of the rectal carcinoma in a Moroccan hospital service, and to discuss the possibility of screening in our practice. Methods: We retrospectively studied 232 cases of rectal cancer collected between January 2000 to December 2008, at Surgical Department, ‘‘C’’ CHU IBN SINA, in Rabat ‘‘Morocco’’. Results: 232 patients were managed during the study period with an average of 30 cases per year. The mean age of patients was 52.8 ± 15.4 years with 25.9% patients below 40 years of age. There were 40% females and 60% males. A history of familial polyposis adenoma was found in 3 cases, HNPCC in 6 cases and inflammatory bowel disease in 2 cases. The mean diagnostic delay was 9 months and most common revealing symptoms were rectal bleeding (80%). Lower rectum was involved in 43.5%. Patients (51%) presented at advanced stages with 21% lymph node metasteses and 13% liver metastases diagnosed in CT scan. The histology showed: adenocarcinoma well-differentiated in 63.1%, moderately-differentiated in 20.2%, poorly- differentiated in 2%, colloidal adenocarcinoma in 16.4%, isolated cells in 3%. The radiotherapy preceded the surgery in 46% of cases and associated at the chemotherapy in 7.6%. The operability rate was 75.4% and resecability rate was of 71.9%. Relapse occurred in 9.1%: Local in 47.6% and metastasis in 52.4% (liver: 14.3%, lung: 9.5%, brain: 9.5%, ovary and peritoneum in 4.8%). At five years, the survival was: 34%.
AB28
Conclusion: There is a need to increase awareness through public education about this malignancy and its management. Any adult with blood in the stool or features of haemorrhoids should be adequately investigated with digital rectal examination and colonoscopy. doi:10.1016/j.ajg.2009.07.177
(052) Epidemiological aspects of anal cancer: About a Moroccan hospital department experience H. El Mernissi, L. Ouazzani, I. Errabih, H. Krami, N. Benzzoubeir, H. Ouazzani Hepato-Gastroenterology Unit ‘‘B’’, University Hospital, Ibn Sina, Rabat, Morocco
Background: Anal cancer is rare, representing 1–2% of gastrointestinal cancers and 6% of colorectal cancers, affecting mostly women of 60ans, the initial symptoms are poor. This is a squamous cell carcinoma in 95% of cases. The locoregional evolution is slow. Aim: The aim of our study is to determine epidemiologic characteristics, investigate important risk factors associated with anal cancer in a Moroccan population and compare our data with international publications. Methods: The study was carried out in the medical service ‘‘Medicine B’’. All anal cancer patients diagnosed during the period from January 2000 to December 2007 were included in the study. Results: 20 cases of anal cancer were found during this period, representing 0, 22% of total hospitalizations, 2.4% of all digestive cancer and 7.5% of colorectal cancers. The mean age was 60 years (range 33–87 years), male to female ratio was 4 (4H/1F). Clinical symptommatology has been dominated by anal pain (80%), rectal bleeding (60%). At endoscopy examination, 65% presented as vegetante lesion and 35% as ulceration. 90% of our patients had squamous cell carcinoma and too had melanoma. Hepatic metastasis was found in 15%. Stage of disease was T2N0 in 85%, T3N2 in 15%. Our patients had radiotherapy exclusively in 75%, radio chemotherapy in 15%, surgery and radiochemistry for patient with melanoma (10%). Conclusion: Anal cancer is rare; it is mostly a squamous cell carcinoma. Treatment is mainly based on radiotherapy. The prognosis depends on early diagnosis and treatment. doi:10.1016/j.ajg.2009.07.178
(053) Did the epidemiological profile and the management of rectal cancer changed? G. Drissi, M. Allaoui, M. Chaourak, M. Faik, M. Raiss, F. Sebbah, A. Benamer, A. Hrora, M. Ahllat Surgical C Clinic, Pr A Tounsi, Ibn Sina Hospital, Morocco
Background: The aim of this study was to compare it epidemiological profiles and the management of rectal cancer between two series collected to 13 years of interval. Methods: It is about two retrospective cases, the first one, collected from 1981 to 1985 (series A), includes 80 patients. The second one, recent, collected from 1998 to 2002 (series R), includes 94 patients. We analyzed for the epidemiological profile, the middle number of case per year, age, sex, seat of the tumor, histological type, metastatic stage. We analyzed for the management: operability rate, resection rate, type of intervention. Results: The middle number of cancer of the rectum hospitalized per year in our formation is respectively 16 ± 4.06 and 18 ± 4.14 in