Clinical presentation and management patterns of colorectal malignancy: A prospective observational study

Abstract

Background: Colorectal malignancy remains a major cause of cancer burden worldwide. Early diagnosis significantly improves outcomes; however, late presentation is common in low-resource settings.

Aim: To evaluate clinical presentation, diagnostic characteristics, and management outcomes of colorectal malignancy in patients presenting to a tertiary care center.

Methods: This prospective observational study was conducted in the Department of General Surgery, GSL Medical College, Rajahmundry, from October 2019 to May 2020. Consecutive patients aged ≥18 years with suspected colorectal cancer were evaluated through detailed clinical history, physical examination, colonoscopy with biopsy, and imaging. Tumors were staged using AJCC TNM classification, and management decisions were made based on operability and disease stage. Treatment modalities included curative resection, diversion procedures, and chemoradiotherapy for rectal malignancies. Early postoperative complications and in-hospital outcomes were recorded.

Results: Of 72 patients, most presented with altered bowel habits (66.7%) and rectal bleeding (56.9%). Colon was the predominant tumor site (62.5%). Majority presented with Stage III (37.5%) or Stage IV disease (27.8%). Curative surgery was performed in 54.2%, while 19.4% required palliative procedures. Postoperative complications occurred in 23.6%, and mortality was 5.6%.

Conclusion: Most patients presented with advanced disease, emphasizing the need for early diagnosis, improved awareness, and strengthened multidisciplinary care.

Keywords:  Colorectal malignancy, Clinical presentation, Study, Management outcomes, Tertiary care center