Survival Following Colorectal Cancer Surgery in Low- and Middle-Income Countries: A Systematic Review and...

Area of Science:

• Oncology
• Global Health
• Surgical Outcomes

Background:

• Colorectal cancer (CRC) surgery is a primary treatment for localized disease.
• Limited data exists on long-term survival outcomes following CRC surgery in low- and middle-income countries (LMICs).

Purpose of the Study:

• To examine survival outcomes after colorectal cancer (CRC) resections in low- and middle-income countries (LMICs).
• To identify survival rates and variations in CRC patients undergoing surgery in LMICs.

Main Methods:

• A systematic review and meta-analysis of primary research studies reporting survival data after CRC resection with curative intent in LMICs.
• Extracted disease-free survival (DFS) and overall survival (OS) data.
• Utilized random effects modeling to estimate pooled survival rates.

Main Results:

• Analyzed 154 studies involving 20,589 CRC patients, with only 27 LMICs represented.
• Pooled 5-year OS estimates: Stage I (88%), Stage II (76%), Stage III (57%).
• Pooled 5-year DFS estimates: Stage I (82%), Stage II (76%), Stage III (59%).
• Combined 5-year OS and DFS were 76% and 69%, respectively, with considerable variation.

Conclusions:

• Highlights a significant lack of data on long-term outcomes for colorectal cancer (CRC) surgery in most LMICs.
• Emphasizes the urgent need for research capacity building in LMICs to improve understanding of CRC surgical outcomes.
• Addresses the rising global incidence of CRC and the implications for patient care in resource-limited settings.