Curative Surgery Improves Survival for Colorectal Cancer in Rural Kenya.

摘要: Colorectal cancer (CRC) is increasing in low- and middle-income countries. Surgical care essential for the treatment. Many patients do not have access to curative surgery colorectal rural Kenya. To better understand impact of surgical on a resource-limited setting, we compared experience undergoing operations those who did not. All with histologically confirmed CRC at Tenwek Hospital from January 1, 1999, December 31, 2017, were reviewed. Demographic clinical data extracted records when available. The exposure was either operation, palliative or no operation. primary outcome survival 5 years, assessed Cox proportional hazard analysis after propensity-score matching age, sex, tumor site, time period, stage. One hundred sixty-five identified chart review. Survival information available 150 median follow-up 319 days. Fifty-two percent had colon 48% rectal cancer. At diagnosis, mean age 55.4 years (SD: 16.7) male female ratio 1.1:1. Thirty-nine underwent operations, 25% 36% operations. One-year estimated be 98% surgery, 73% 83% (p = 0.0005). On crude analysis, 5-year improved operation comparison 0.30 (CI: 0.14–0.64) (p = 0.002). After propensity matching, versus remained significant, 0.34 0.14–0.80) (p = 0.01). Curative improves our environment. Although various factors contribute use treatment, advantage persists adjusted analysis. Barriers exist prompt evaluation should priority address burden settings.