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April 11, 2026Scientific Reports0 citationsOpen Access

Clinical profile, treatment patterns, and early outcomes of colorectal cancer at Kassala Police Hospital, Eastern Sudan: a 10-year retrospective cohort study

AEAbdel Latif Khalifa ElnaimKassala University SASuzan Mounir AliKassala University RARawah Suliman Mohamed AhmedKassala University

Key Points

This study aims to explore the clinical profile, treatment patterns, and early outcomes of colorectal cancer patients in Eastern Sudan.
Retrospective cohort design examining patients who underwent colonic or rectal resection from June 2013 to June 2023.
Data extraction included demographic, clinical, operative, oncologic, and outcome variables.
Bivariate analysis was conducted using Fisher’s exact tests, χ² tests, t-tests, and ANOVA.
Multivariable logistic and linear regression models identified independent predictors of outcomes.
Kaplan–Meier and Cox proportional hazards models analyzed time-to-event outcomes with competing-risk analysis for recurrence.
Study included 604 patients, predominantly male, with a mean age of 53.5 years.
82.0% had stage II disease, with 25.8% presenting as emergencies; common tumors were rectal and left-sided cancers.
Emergency surgeries linked to higher rates of morbidity, mortality, and recurrence (p < 0.001).
Independent predictors of mortality included advanced stage and emergency operations, while recurrence was influenced by tumor location.
Rectal cancers showed the highest recurrence rate at 26.3% due to limited access to multimodal therapy.

Abstract

In low-resource settings with limited access to multimodal care, colorectal cancer is characterized by delayed diagnosis and a high incidence of emergency presentation. Robust contemporary longitudinal data from Eastern Sudan are scarce. This is a retrospective cohort study recruiting all patients who underwent colonic or rectal resection for colorectal cancer between June 2013 and June 2023. Extracted data included demographic, clinical, operative, oncologic, and outcome variables. Fisher’s exact tests, χ² tests, t-tests and ANOVA were used for bivariate analysis. Independent predictors of outcomes were identified using multivariable logistic and linear regression models. Kaplan–Meier methods and Cox proportional hazards models were used to analyze time-to-event outcomes, with competing-risk analysis applied for recurrence. The study included 604 patients (59.4% male), with a mean age of 53.5 years. Most patients (495/604, 82.0%) had stage II disease, emergency cases were 25.8% (156/604), while 63.2% of cases were rectal and left-sided cancers. A statistically significant association was identified between emergency surgery and advanced stage, higher morbidity, anastomotic leak, intensive care unit admission, mortality, and recurrence (p < 0.001). Multivariable analysis revealed that independent predictors of mortality included advanced stage, emergency operation, advanced age, postoperative morbidity, and intensive care unit admission. Predictors of recurrence included advanced stage and left-sided/rectal tumor location. Hospital stay was significantly prolonged by postoperative morbidity and stoma formation. The highest recurrence rate (26.3%) occurred with rectal cancers, with underutilization of neoadjuvant and radiotherapy. In Eastern Sudan, a significant portion of colorectal cancer presents as an emergency at an advanced stage, associated with high rates of morbidity, recurrence and mortality. While rectal tumors were disadvantaged by limited access to multimodal therapy, right-sided tumor location was protective. For survival and other outcomes, there is an urgent need for earlier detection and increased accessibility to chemoradiotherapy.

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