Colorectal cancer patients in western Saudi Arabia: Outcomes and predictors for survival over a 10-years period (2002-2014)

OBJECTIVES: To determine the survival outcomes and to describe the epidemiological characteristics of patients with colorectal cancer (CRC) in western Saudi Arabia. METHODS: Our study is a retrospective analysis of patients with CRC diagnosed between 2002 and 2014. We recruited 279 patients who were selected randomly and followed until the end of July 2017. A Kaplan-Meier curve was used to estimate the survival rate for CRC patients according to gender, histopathological pattern, tumor site, and mutation type, taking into consideration time factor, dropouts, and loss to follow-up. RESULTS: The mean age of CRC patients was 57±13 years, and most of them were Saudi (87.5%). Regarding tumor epidemiology, 32.4% of the patients at Best American Joint Committee on Cancer (Best AJCC) stage 4; 28.9% were at stage 3; and 1.2% were at stage zero. The most frequent pathological variant was adenocarcinoma (77.4%); the most affected site was the rectum (40.5%). By Cox regression analysis, age at diagnosis, tumor stage, Kirsten Ras (KRAS) mutation, and lymphovascular invasion were significant prognostic factors for survival in CRC patients. CONCLUSION: Colorectal cancer patients presented to the hospital late in the disease course. This may call for lowering the screening age, increasing awareness programs, and establishing a national screening program.