Journal of cancer & allied specialties最新文献

{"title":"Outcomes of Medulloblastoma Treated with Volumetric Modulated Arc Therapy Craniospinal Irradiation: A Retrospective Study.","authors":"Muhammad Anas Tahseen Asar, Tabinda Sadaf, Asma Rashid, Aqueel Shahid, Fajar Rafi Ranjha, Raheel Mukhtar, Haniya Rizwan, Ahmad Rashid","doi":"10.2478/jcas-2026-0006","DOIUrl":"https://doi.org/10.2478/jcas-2026-0006","url":null,"abstract":"<p><strong>Introduction: </strong>Cranio-spinal irradiation (CSI) is essential in treating central nervous system malignancies such as medulloblastoma, but conventional 3D-conformal radiotherapy poses challenges in dose uniformity and toxicity. Advanced techniques like Volumetric Modulated Arc Therapy (VMAT) offer improved target coverage and organ sparing, yet data on its use in resource-limited settings remain scarce. This study aimed to evaluate the clinical feasibility, dosimetric performance, toxicity profile, and early outcomes of CSI delivered via VMAT in medulloblastoma patients treated at a tertiary care center in Pakistan.</p><p><strong>Materials and methods: </strong>This retrospective study included 113 patients (median age 12 years, range 4-37) diagnosed with medulloblastoma and treated between 2018 and 2024. Patients underwent surgical resection followed by VMAT-based CSI, with doses ranging from 23.4 to 36 Gy and tumor boosts of 54-55.4 Gy. Dosimetric parameters including planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), and organ-at-risk (OAR) doses were analyzed. Acute toxicities were graded, and disease-free survival (DFS) was assessed over a median follow-up of 15 months.</p><p><strong>Results: </strong>Gross total or near-total resection was achieved in 38.1% of patients. Mean PTV coverage was 94%, with median CI and HI values of 1.02 and 0.10, respectively, indicating excellent dose conformity and homogeneity. The majority of patients required multiple isocenters for complete cranio-spinal coverage. Acute toxicities were predominantly mild to moderate, with esophagitis (11%), bone marrow suppression (12%), and nausea/vomiting (10%) most commonly observed. Organ doses remained within acceptable limits. The two-year DFS rate was 76%.</p><p><strong>Conclusion: </strong>VMAT-based CSI is a feasible and effective treatment modality for medulloblastoma in a resource-constrained setting, providing superior dosimetric outcomes with manageable toxicity. These findings support the broader adoption of advanced radio-therapy techniques like VMAT in similar clinical environments.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"40-45"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of Metastatic Colorectal Carcinoma at a Tertiary Care Center in Pakistan.","authors":"Sehar Salim Virani, Muhammad Taha Nasim, Fiza Adnan, Muhammad Ibrahim, Munira Shabbir Moosajee, Muhammad Rizwan Khan, Kulsoom Ghias, Muhammad Murtaza, Sadaf Khan, Syed Nabeel Zafar","doi":"10.2478/jcas-2026-0001","DOIUrl":"https://doi.org/10.2478/jcas-2026-0001","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic colorectal cancer (mCRC) poses significant challenges in low- and middle-income countries (LMICs) due to limited access to comprehensive care. This study aims to analyze the clinical characteristics, treatment patterns, and outcomes of patients with metastatic colorectal cancer (mCRC) at a single tertiary care center in Pakistan.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study was conducted on 141 patients diagnosed with mCRC at the Aga Khan University Hospital (AKUH) between January 2020 and December 2022. Data on demographics, tumor characteristics, metastasis patterns, treatment modalities, and outcomes were extracted from electronic medical records. Descriptive statistics and survival analysis were performed.</p><p><strong>Results: </strong>The mean age of the cohort was 51 years (SD ± 17.43), with 56.7% male patients. The study included patients from all over Pakistan, with the majority residing in Sindh (71.1%). Additionally, 8.5% of patients were from outside Pakistan. Rectum (27.5%) and sigmoid colon (20.4%) were the predominant tumor locations. Adenocarcinoma was the most common histological type (90.1%). Liver-only metastases were observed in 27.5% of patients, with 48.2% presenting multisite metastases. Chemotherapy was administered to 74.6% of patients, with FOLFOX being the most common regimen (38.3%). Primary tumor resection was performed in 43.7% of cases, and metastatic lesion resection in 7.7%. Fragmented care was observed, with 21.4% of patients receiving diagnostic or therapeutic interventions outside AKUH as well. The median time from diagnosis of metastasis to death was 4.9 months (IQR: 1.1-9.3).</p><p><strong>Conclusion: </strong>mCRC patients in Pakistan present with a younger age, higher prevalence of multisite metastases, and limited access to advanced multimodal treatments compared to HICs. These findings underscore the need for tailored public health initiatives, including age-specific screening programs, improved diagnostic and treatment infrastructure, and enhanced access to advanced therapies to improve outcomes in LMICs.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brown Tumor in Primary Hyperparathyroidism and Hungry Bone Syndrome Post-Parathyroidectomy: Two Rare Entities.","authors":"Tanveer Fatima, Maryam Arshad, Zainab Ajmal, Ahmed Imran Siddiqi, Waqas Shafiq","doi":"10.2478/jcas-2026-0007","DOIUrl":"https://doi.org/10.2478/jcas-2026-0007","url":null,"abstract":"","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Esophageal Stenting in Managing Esophageal Tumor Perforation: A Retrospective Study.","authors":"Zainab Shakeel, Muhammad Kashan Sajid, Amer Rehman Farooqi, Samar Minallah, Zubair Shabbir Khanzada, Farhan Ali","doi":"10.2478/jcas-2026-0003","DOIUrl":"https://doi.org/10.2478/jcas-2026-0003","url":null,"abstract":"<p><strong>Introduction: </strong>Esophageal tumor perforation is a serious complication, seen in patients undergoing chemo-radiotherapy for advanced-stage cancer, and can lead to life-threatening conditions like sepsis and empyema. Esophageal stenting with self-expandable metal stents offers a safer, less invasive alternative to surgery, helping restore oral intake and improve patient comfort. This study aims to determine the effectiveness of esophageal stenting in managing esophageal tumor perforation at different disease stages and to assess long-term outcomes.</p><p><strong>Material and method: </strong>This retrospective cohort study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center in Peshawar by reviewing 600 patient records presenting with esophageal tumor perforation from January 2016 to December 2021, and retracted between October and December 2024. Eighty patients who underwent esophageal stenting were enrolled in the study. Data on demographics, tumor characteristics, treatment history, and survival status were collected from the hospital's electronic system. SPSS-25 was used for analysis purposes. The chi-square test was employed to determine statistical significance (p ≤ 0.05).</p><p><strong>Results: </strong>The mean age of patients was 46.98±11.62 years, and most patients were male (45, 56.3%). Squamous cell carcinoma was the most prevalent histological type, accounting for 74(92.5%) of cases. Advanced-stage disease was observed in the majority of cases, with T3 at 48 (60.5%) and T4 at 15 (18.8%). Additionally, 34(42.5%) exhibited nodal involvement (N1 and N2 each) and 23(28.7%) had metastatic. The median stent insertion during the study period was 83 days, with a range from 1 day to 7 years. Survival status was suboptimal, with 76(95%) deceased, 4(5%) surviving. Kaplan-Meier analysis demonstrates a median survival of 200 days.</p><p><strong>Conclusion: </strong>Esophageal stenting is an effective palliative intervention for managing tumor-induced esophageal perforation, particularly in patients with advanced disease, and prolongs survival.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Pediatric and Adolescent Girls with Malignant Ovarian Germ Cell Tumors after Chemotherapy and Surgery: A Single Institutional Experience.","authors":"Niaz Ali, Rabia Muhammad Wali, Aqeela Rashid, Naila Inayat, Misbah Zainab, Sajid Ali, Syeda Tehreem Zahra Gillani, Najma Shaheen","doi":"10.2478/jcas-2026-0005","DOIUrl":"https://doi.org/10.2478/jcas-2026-0005","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant ovarian germ cell tumors are rare and vital cancers in the pediatric age group of females, affecting 1-2% of all ovarian malignancies. Advances in surgical management, chemotherapy, and patient care have significantly improved survival.</p><p><strong>Materials and methods: </strong>This retrospective study investigates the treatment outcomes of 116 pediatric patients diagnosed with Malignant ovarian germ cell tumors at a tertiary care center in Pakistan between 1999 and 2022. The study focuses on patterns of care, survival rates, recurrence, and complications associated with therapy.</p><p><strong>Results: </strong>The median age was 13.5 years, with dysgerminomas predominating (38.7%). Most patients had upfront surgery (87.9%), followed by adjuvant chemotherapy, including JEB (Carboplatin, etoposide, bleomycin) (64.7%), BEP (bleomycin, etoposide, cisplatin) (25.0%), and PEB (cisplatin, Etoposide, Bleomycin) (4.3%). The five-year event-free survival (EFS) and overall survival (OS) were 87.1% and 90.5%, respectively. Histology, chemotherapy regimen, and risk group classification were key factors influencing survival, with dysgerminoma showing the best prognosis. In patients whose tumor markers normalized rapidly, event-free survival (EFS) was better. Relapsed disease was observed in 2.6% of patients, and disease progression occurred in 7.8%.</p><p><strong>Conclusion: </strong>Our study shows good outcomes for girls with ovarian tumors. This study highlights the effectiveness of multimodal treatment strategies, including both surgery and chemotherapy, in improving survival outcomes for pediatric patients with malignant ovarian germ cell tumors in low-resource settings.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Palliative Care for Terminally Ill Children in a Developing Country Cancer Hospital: A Qualitative Study.","authors":"Saba Khurshid, Atif Saleem, Zubair S Khanzada","doi":"10.2478/jcas-2026-0004","DOIUrl":"https://doi.org/10.2478/jcas-2026-0004","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric palliative care (PPC) aims to improve the quality of life for children with life-limiting illnesses and support their families by addressing physical, psychological, social, and spiritual needs. Globally, significant barriers to PPC delivery include limited integration into health systems, inadequate provider training, restricted access to pain medications, and communication challenges. These issues are particularly pronounced in low- and middle-income countries, where cultural, infrastructural, and resource constraints further complicate care. Despite growing recognition of PPC's importance, there is limited understanding of the experiences of children, families, and healthcare providers in these contexts. This study explores barriers to PPC provision in a developing-country cancer hospital, highlighting context-specific challenges and opportunities for improvement.</p><p><strong>Materials and methods: </strong>A retrospective qualitative content analysis of clinical documentation was conducted for 150 pediatric patients (≤18 years) referred to the palliative medicine team at a tertiary care cancer hospital between 1st January 2019 and 27th August 2024, at which point thematic saturation was achieved. Clinical notes were analyzed using Braun and Clarke's thematic analysis framework and coded in NVivo 15. Key themes and subthemes emerged. Ethical approval was obtained from the Institutional Review Board.</p><p><strong>Results: </strong>Five themes were identified as challenges in palliative care provision to children. These were barriers to effective care, psychological and family-related challenges, impact on quality of life, financial constraints and resource limitations, medical adherence, and treatment non-compliance.</p><p><strong>Conclusion: </strong>These findings underscore the urgent need to address multifaceted medical, psychosocial, and socioeconomic challenges to pediatric palliative care in developing countries. Prioritizing a multidisciplinary approach, raising awareness, expanding access to pain management, and reinforcing psychosocial support are imperative steps. Through concerted efforts, the quality of life for children with life-limiting illnesses and their families can be meaningfully improved.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Technical Feasibility and Surgical Outcomes of Laparoscopic Excision of Abdominopelvic Solid Tumors in Children: A Retrospective Review.","authors":"Sajid Ali, Muhammad Bilal Qayyum, Muniba Jalil, Tariq Latif, Aamir Ali Syed, Muhammad Ali Sheikh","doi":"10.2478/jcas-2026-0002","DOIUrl":"https://doi.org/10.2478/jcas-2026-0002","url":null,"abstract":"<p><strong>Introduction: </strong>Minimal invasive surgery for abdominopelvic solid organ tumors in paediatric patients is a growing field. Technical challenges persist despite potential benefits, such as reduced postoperative pain and shorter recovery times.</p><p><strong>Materials and methods: </strong>This was a retrospective review of all paediatric patients who underwent laparoscopic excision for abdominopelvic tumors. Parameters such as demographics, tumor histology, tumor location and size, blood loss, operation duration, and early outcomes were analyzed.</p><p><strong>Results: </strong>Thirty-five patients underwent laparoscopy. The median age was 13 years. Females constituted the majority (29). Tumor sites included the pelvis (n=29), right kidney (n=2), retroperitoneal (n=3), and colon (n=1). The average tumor size was 11 cm. Successful laparoscopic excision was achieved in 32 cases, without postoperative complications, with a mean hospital stay of two days.</p><p><strong>Conclusions: </strong>Laparoscopic excision is technically feasible for paediatric abdominopelvic solid organ tumors, offering minimal complications. However, further studies are needed to define long-term outcomes.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Tumor Grade Have any Prognostic Significance in Chromophobe Renal Cell Carcinoma: A Clinicopathological Study.","authors":"Shariqah Sadaf, Sajid Mushtaq, Madiha Syed, Usman Hassan, Mudassar Hussain, Asif Loya, Maryam Hameed, Umer Nisar Sheikh","doi":"10.2478/jcas-2025-0009","DOIUrl":"https://doi.org/10.2478/jcas-2025-0009","url":null,"abstract":"<p><strong>Introduction: </strong>Chromophobe renal cell carcinoma (CHRCC) is the third most common RCC subtype, typically with a favorable prognosis, though some cases show aggressive behavior. The prognostic utility of tumor grading in CHRCC remains controversial, particularly regarding the Fuhrman grading system due to inherent nuclear atypia. The Paner et al. three-tiered chromophobe tumor grading (CTG) system addresses these limitations by incorporating nuclear crowding and anaplasia. This study evaluates CTG's prognostic value versus Fuhrman grading and other factors like pT stage, sarcomatoid differentiation, and tumor necrosis.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 51 patients who underwent radical nephrectomy for chromophobe renal cell carcinoma (CHRCC) at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, between 2014 and 2019. Tumors were graded using the Fuhrman and Paner CTG systems. Prognostic factors assessed included pT stage, sarcomatoid differentiation, and tumor necrosis. Statistical analysis used Chi-square and independent sample T-tests. Survival analysis was performed using Kaplan-Meier curves to determine overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS).</p><p><strong>Results: </strong>Most cases (68.6%) were CTG grade 1-2, and 31.4% were grade 3. All adverse events occurred in grade 3 tumors (DMFS 75%, RFS 93.8%, CSS 87.5%). Grades 1-2 had 100% survival. Fuhrman grading showed less prognostic relevance due to inconsistent results. Tumor necrosis and advanced pT stage correlated with poor outcomes. Sarcomatoid differentiation appeared in one of four progressing cases.</p><p><strong>Conclusion: </strong>The Paner CTG system effectively stratifies CHRCC patients by prognostic risk. It outperforms Fuhrman grading in predicting adverse outcomes. Higher tumor grade, necrosis, and advanced pT stage all significantly correlated with poor prognosis. These findings support adopting the Paner grading system for CHRCC to improve risk stratification and clinical decisions. Larger studies are warranted to validate these results.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"11 1","pages":"51-61"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periampullary adenoma leading to duodenojejunal intussusception in a young woman: A case report.","authors":"Abu Bakar Bhatti, Usman Shafique Khokhar, Hajira Ghairat","doi":"10.2478/jcas-2025-0010","DOIUrl":"https://doi.org/10.2478/jcas-2025-0010","url":null,"abstract":"<p><strong>Background: </strong>Duodenojejunal intussusception (DJI) is an uncommon clinical entity in adults, most often secondary to an underlying structural lesion. Its nonspecific gastrointestinal symptoms and rarity frequently delay diagnosis and complicate management.</p><p><strong>Case description: </strong>We present the case of a 30-year-old woman with an 18-month history of right hypochondrial pain, intermittent non-bilious vomiting, and significant weight loss. Imaging and endoscopic biopsy revealed duodenojejunal intussusception secondary to a large periampullary tubulovillous adenoma. Although a transduodenal ampullectomy was initially planned, the procedure was converted to a pancreaticoduodenectomy due to the lesion's size and morphology. The postoperative course was uneventful, and the patient has remained asymptomatic and in good health for more than fifteen months after surgery.</p><p><strong>Practical implications: </strong>DJI secondary to periampullary adenoma is rare but clinically significant. While endoscopic or limited surgical resection may be appropriate in select cases, pancreaticoduodenectomy offers a definitive treatment option when ampullectomy is not feasible.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"11 1","pages":"63-66"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of Metastatic Colorectal Carcinoma at a Tertiary Care Center in Pakistan.","authors":"Sehar Salim Virani, Muhammad Taha Nasim, Fiza Adnan, Muhammad Ibrahim, Munira Shabbir Moosajee, Muhammad Rizwan Khan, Kulsoom Ghias, Muhammad Murtaza, Sadaf Khan, Syed Nabeel Zafar","doi":"10.2478/jcas-2025-0008","DOIUrl":"https://doi.org/10.2478/jcas-2025-0008","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic colorectal cancer (mCRC) poses significant challenges in low- and middle-income countries (LMICs) due to limited access to comprehensive care. This study aims to analyze the clinical characteristics, treatment patterns, and outcomes of patients with metastatic colorectal cancer (mCRC) at a single tertiary care center in Pakistan.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study was conducted on 141 patients diagnosed with mCRC at the Aga Khan University Hospital (AKUH) between January 2020 and December 2022. Data on demographics, tumor characteristics, metastasis patterns, treatment modalities, and outcomes were extracted from electronic medical records. Descriptive statistics and survival analysis were performed.</p><p><strong>Results: </strong>The mean age of the cohort was 51 years (SD ± 17.43), with 56.7% male patients. The study included patients from all over Pakistan, with the majority residing in Sindh (71.1%). Additionally, 8.5% of patients were from outside Pakistan. Rectum (27.5%) and sigmoid colon (20.4%) were the predominant tumor locations. Adenocarcinoma was the most common histological type (90.1%). Liver-only metastases were observed in 27.5% of patients, with 48.2% presenting multisite metastases. Chemotherapy was administered to 74.6% of patients, with FOLFOX being the most common regimen (38.3%). Primary tumor resection was performed in 43.7% of cases, and metastatic lesion resection in 7.7%. Fragmented care was observed, with 21.4% of patients receiving diagnostic or therapeutic interventions outside AKUH as well. The median time from diagnosis of metastasis to death was 4.9 months (IQR: 1.1-9.3).</p><p><strong>Conclusion: </strong>mCRC patients in Pakistan present with a younger age, higher prevalence of multisite metastases, and limited access to advanced multimodal treatments compared to HICs. These findings underscore the need for tailored public health initiatives, including age-specific screening programs, improved diagnostic and treatment infrastructure, and enhanced access to advanced therapies to improve outcomes in LMICs.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"11 1","pages":"40-50"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}