الفهرس 
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Abstract
Colorectal cancer is a common malignancy. However, the clinicopathological pattern of colorectal cancer in Suez canal area is still unknown. Descriptive epidemiology is essential to better understanding of the etiology of the disease and the development of preventive strategies.
This descriptive study was designed to identify the pattern of colorectal cancer in patients presented to Suez canal university center of oncology and nuclear medicine between 1/1/1995 and 1/1/2012.
The data required for this descriptive study was collected from the file recording system of Suez canal university center of oncology and nuclear medicine. A structural format was used to obtain demographic , clinical , laboratory , radiological , pathological , treatment and follow up data for each patient. Alive patients were contacted in order to complete the missing data and were regularly followed up every two weeks.
8320 cancer patients were seen at Suez canal university center of oncology and nuclear medicine between 1995-2012. Colorectal cancer was documented in 146 patients representing a relative frequency of 1.75% from total cases. The records of these patients were reviewed.
Our results showed that the age of our patients ranged between <20 years and >60 years with maximum number of patients between the age of 40-59 years. Females slightly outnumbered the males with a female to male ratio 1.03:1.
The commonest presenting symptoms were abdominal and pelvic pain in 22.6% , bleeding per rectum in 20.56% and change in bowel habits in 19.86%.
The commonest tumor site was the right and left colon representing about (27.40%) ,followed by rectum (26.71%).
The commonest gross pathology was the exophytic mass documented in 76 patients (52.06%). All of our patients had adenocarcinoma.
Out of 146 patients included in our study,107 patients were colon cancer and 39 patients were rectal carcinoma. 86 patients were non metastatic colon cancer and 21 patients were metastatic from the start, also 32 patients were non metastatic rectal carcinoma and 7 patients were metastaic from the start.
Lymph node assessment revealed that 68 patients (53.54%) were negative and 59 patients (46.46%) were positive.
Serum CEA level was elevated in 109 patients (73.15%) and CA19.9 was elevated in 97 patients(66.44%).
Radical surgical procedures were done in 126 patients 86.27%. Chemotherapy was given to 109 patients(73.97%) , concomittent chemotherapy and radiotherapy were given to 37 patients(25.34%).
The most chemotherapy given to our patient as a first line was degramaunt , given to 36 patients(33.33%), followed by mayoclinic regimen (25%) and folfox(23.15%).
After receiving first line chemotherapy , the response was monitored. 67 patients showed complete response after receiving first line chemotherapy , 26 patients showed partial response and 21 patients showed stable disease.
Only 35 patients receive second line chemotherapy and one hundred and eleven patients (76.03%) did not receive second line chemotherapy.
After receiving second line chemotherapy , 15 patients (42.86%) showed partial response, 15 patients (42.86%) showed stable disease , three patients showed complete response and 2 patients showed progression.
In conclusion , colorectal carcinoma is a relatively common malignancy at Suez canal university center of oncology and nuclear medicine and population studies are needed to determine the prevalence of the disease in general population.
Screening programs are needed to be implicated at the level of primary health care for high risk groups. Management of colorectal cancer should be done by a team approach.