Clinical and Treatment Profile with Five Year Survival Analysis of Colorectal Cancer from Himalayan State of India

Abstract Background: The incidence of colorectal cancer (CRC) is increasing worldwide. Middle- and low-income countries are also experiencing increases in these cases. This is attributed to their large and rapidly growing populations coupled with the adoption of westernized diets and lifestyles. Methods: All diagnosed cases of colorectal cancer presenting to IGMC, Shimla (the sole tertiary cancer care centre in the state of Himachal Pradesh, India) within the study period of January 2017 to December 2018 were included. Data on the clinical characteristics, pathology, treatment received, and survival outcomes were recorded. A Kaplan–Meier estimation of survival, defined as the time from presentation to death, was conducted within the follow-up period of 60 months (last follow-up 31st December 2023). Results: The study included 165 patients, with a male predominance, mean age of 56.8 years, and 34% aged <50 years. The most prevalent symptoms were anorexia and weight loss (97%), and the rectum was the most common site (42%). Histopathological signet ring-type morphology was observed in 15% of the cases, and the majority of patients presented with advanced stages III (36%) and IV (32%). Radiation oncologists, surgeons, and medical oncologists employed a multimodal treatment approach. After 60 months of follow-up, 22 patients were lost to follow-up and only 23 remained alive. Kaplan–Meier analysis revealed that clinical stage was a significant factor for survival, with a five year survival of 31%. Conclusion: Most patients presented at an advanced stage with a significantly young population, which not only resulted in complex management but also poor survival outcomes. Further epidemiological studies, including genetic analyses, are necessary to characterize the presentation of colorectal cancer in our state.