Clinicopathological Profile and Tnm Stage Distribution of Colorectal Adenocarcinoma

Abstract

Background: Colorectal cancer (CRC) stands as a formidable global health challenge, representing the third most commonly
diagnosed malignancy and the second leading cause of cancer-related mortality worldwide. From a histopathological perspective,
the landscape of CRC is dominated by adenocarcinoma. The clinical impact of colorectal adenocarcinoma is intrinsically linked to
the stage at which the disease is detected. Accurate pathological staging and identification of adverse histopathological features are
therefore essential for prognosis and treatment planning.
Methods: This prospective observational study included 50 consecutive patients with a new, histologically confirmed diagnosis
of colorectal adenocarcinoma at a tertiary care hospital. Demographic and clinical characteristics, tumor localization, histological
grade, lymphovascular invasion (LVI), perineural invasion (PNI), and TNM stage were evaluated. Patients were stratified into three
age groups: <40 years, 40-59 years, and ≥60 years. Pathological staging was performed according to the eighth edition of the AJCC/
UICC TNM staging system. Associations between categorical variables were assessed using the Chi-square test or Fisher’s exact test,
as appropriate. A p-value of less than 0.05 was considered statistically significant.
Results: The mean age of the study cohort was 57.8 ± 12.1 years, with 46.0% of patients aged ≥60 years. Males constituted 64.0%
of the cohort. Rectal bleeding was the most common presenting symptom (62.0%), followed by altered bowel habits (56.0%) and
abdominal pain (44.0%). The rectum was the most common primary tumor site (42.0%), followed by the left colon (36.0%) and right
colon (22.0%). Moderately differentiated adenocarcinoma was the predominant histological grade (64.0%), while poorly differentiated
tumors accounted for 22.0%. LVI was present in 48.0% and PNI in 28.0% of patients. Stage III was the most common stage group
(38.0%), followed by Stage II (26.0%), Stage IV (24.0%), and Stage I (12.0%). Overall, 62.0% of patients presented with Stage III/
IV disease. Advanced stage was significantly associated with older age (p=0.04), poor tumor differentiation (p<0.01), lymph node
positivity (p<0.001), and LVI (p<0.001).
Conclusion: Colorectal adenocarcinoma in the studied population predominantly presented at an advanced stage, particularly among
older male adults. Rectal and left-sided tumors were the most frequent, while poor differentiation, lymph node positivity, and LVI
were strongly associated with advanced disease. These findings emphasize the importance of structured early detection and screening
programs and meticulous histopathological evaluation for appropriate stage-based management.