Data in the treatment of colon cancer from real clinical practice in Tashkent, Uzbekistan

Background. Colon cancer (CC) is the 2nd leading cause of cancer death and the 3rd most common cancer diagnosed worldwide. The proportion of CC in Uzbekistan accounts for 6.7%. In the overall structure of cancer incidence, CC ranks 5th, in the structure of mortality – 4th place, almost 25 thousand new cases and more than 14 thousand deaths from CC are registered annually. Five-year OS is 34–35%. Statistical information is the basis for developing and monitoring the results of anti-cancer interventions.

Objective. Evaluation of the state of oncological care for patients with CC at the Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology.

Methods. According to retroand prospective analysis, from 2015 to 2022, 250 patients with RTC received treatment at the Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology. Of these, 61 (24%) patients had stage II, 117 (47%) had stage III, and 72 (29%) had stage IV CC. The mean age was 59.2±9.9 years. Damage to the left parts of the intestine predominated (72.8 versus 37.2%), regardless of the stage. Histologically adenocarcinoma – in 97% of casea. Of the 250 patients, 31 (12.4%) received complex treatment, 138 (55.2%) received combined treatment, 81 (32.4%) received conservative treatment. Surgical treatment was performed in 145 (58%) patients, colostomy in 16 (6.4%), surgical treatment and colostomy in 25 (10%), 64 (25.6%) patients were treated without surgery. Radiation therapy was performed in 30 (12%) cases preor postoperatively, 20 (8%) versus 10 (4%) cases, respectively. 26 (10%) patients received targeted therapy. Chemotherapy was administered in 248 (99%) cases. Of these: neoadjuvant – in 39 (15.6%), postoperative – 91 (36.4%), perioperative – 40 (16%=), palliative – 78 (31.2%).

Results. In the structure of morbidity and mortality in the Republic of Uzbekistan, the CC ranks 5th and 4th, respectively. During the follow-up period (mean 26.4±16.0 months, range 1 to 75 months, median 24.2 months), mortality was 145 (58.0%) cases, progression rate was 220 (88.0%). Upstaging worsened OS and progression-free survival (PFS). 2-year OS for stages II, III, and IV was 69.7% (median, 36.9 months), 63.2% (median, 28.4 months), and 21.9% (median, 16.9 months); P=0.000001, respectively. The 2-year PFS for stages II, III, and IV was 52.8% (median, 25.0 months), 30.3% (median, 18.9 months), and 3% (median, 9.5 months); P=0.00001, respectively.

Conclusion. Analysis of statistical information showed that CC is one of the leading pathologies in the structure of cancer morbidity and mortality in Uzbekistan. There has been a steady increase in morbidity and mortality from CC. Taking into account the advanced stage at the initial detection of the tumor, the issues of diagnosing cancer in the early stages remain relevant, and treatment of cancer requires compliance with international standards for the treatment of this pathology.