Biological characteristics predict outcome of rectal cancer patients: Data from tertiary care hospital in a low economic country

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer Care Delivery in Low Resource Environments
Colon and Rectal Cancer
Pathology/Molecular Biology
Presenter adeeba zaki
Citation Annals of Oncology (2018) 29 (suppl_9): ix28-ix45. 10.1093/annonc/mdy431
Authors A. zaki, S. Hirani, S. Sawani, S. Sarwar, M. Moosajee
  • Medical Oncology, The Aga Khan University Hospital, 74800 - Karachi/PK



Management of rectal cancer has been evolved significantly in the last few decades, improvement in disease control were achieved with introduction of neoadjuvant chemoradiation followed by surgical excision. Objective: To determine progression free survival and overall survival of the patients with rectal cancer and various factors that affect survival.


We retrospectively collected data of newly diagnosed patients with rectal cancer presented at Aga Khan University Hospital Karachi, from 2009 to 2016. All the patients with early stage or locally advanced rectal cancer who either underwent upfront surgery or received neoadjuvant chemoradiation followed by surgery were included in the study.


From 2009 to 2016, 101 patients with newly diagnosed rectal carcinoma were included in the study. Median age 47 years (21-80), 66.3 % (n = 67) were males whereas 33.6 % (n = 34) female. 9.90% (n = 10) have signet ring cell histology while 90.1 % (n = 91) are adenocarcinoma. 59.4 % (n = 60) were stage III, 26.7% (n = 27) stage II and 13.8% (n = 14) were stage I at the time of diagnosis, 47.5% (n = 48) underwent upfront surgery while 52.4% (n = 53) received neoadjuvant chemoradiation. 31 patients who underwent upfront surgery completed adjuvant chemoradiation. 51 patient after neoadjuvant chemoradiation underwent surgery, 2 had disease progression. Of them 7 %( n = 4) of the patients had pathological complete response (CR) while 92.1% (n = 47) had non CR. Median follow up was 3 years (1-5 yrs.), 37 pts. had disease progression. Median time to progression of all patients was 21 months and overall survival of 24 months. In subgroup analysis patient with adenocarcinoma had better PFS (21 vs. 19 months) and OS (24 vs. 21 months) as compared to signet ring histology. Patient who had pathological CR after neoadjuvant chemoradiation had a PFS and OS of 32 months respectively vs. 16 and 18 months who had no pathological CR.


Several factors affect survival of rectal cancer patients, our analysis showed that the patients who had pathological complete response and non-signet ring cell histology had better time to progression as that which was reported in international studies.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Aga University Hospital.


Has not received any funding.


All authors have declared no conflicts of interest.