Clinico-pathological and management differences between colorectal cancer sites: a multicenter cross-sectional study in Khartoum state, 2021–2022

Colorectal cancer (CRC) is the third most common cancer worldwide and has a high mortality rate at advanced stages. Researchers suggest that CRC can be divided into three distinct disease entities within the same organ, each with unique clinicopathological, molecular, and histological characteristics: right colon, left colon, and rectal cancers. This study aimed to examine clinicopathological and management differences among colorectal cancer sites in Khartoum State from 2021 to 2022. This multicenter, facility-based, cross-sectional study was conducted in Khartoum State from January 2021 to June 2022. The study included 104 patients who met the inclusion criteria. Participants were followed up for six months, and data were collected using questionnaires and checklists. All participants provided informed consent before data collection. Right-sided colon cancer patients commonly presented with a palpable abdominal mass ( P < 0.001), which was significantly associated with weight loss ( P = 0.03) and iron-deficiency anemia ( P < 0.001). In contrast, left-sided colon cancer patients frequently reported abdominal distension ( P < 0.001), whereas rectal cancer patients predominantly presented with bleeding per rectum ( P < 0.001). Although not statistically significant, patients with right-sided colon cancer showed a trend toward a higher number of removed lymph nodes than those with tumors at other sites ( P = 0.06). In left-sided colon cancer, tumor diameter was moderately positively correlated with the number of removed lymph nodes (Spearman’s correlation coefficient, r = 0.46; coefficient of determination, R² = 0.210). Additionally, patients with rectal and rectosigmoid junction cancers commonly received neoadjuvant chemoradiotherapy ( P = 0.003 ). One patient had recurrence, and no mortality was recorded during the six-month postoperative follow-up period. Tumor location affects the clinical presentation and pathological features of the disease. These differences might be due to the lack of screening programs and the prolonged time for RCC tumors to become clinically overt. Not applicable.