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Colorectal Cancer in Romania: Surgical Strategies, Survival, and Historical Trends in a 302-Patient Cohort

Laurențiu Augustus Barbu, Liliana Cercelaru, Valeriu Şurlin, Stelian Ştefăniţă Mogoantă, Tiberiu Ștefăniță Țenea Cojan, Nicolae-Dragoș Mărgăritescu, Ana-Maria Țenea Cojan, Valentina Căluianu, Gabriel Florin Răzvan Mogoș, Liviu Vasile

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Abstract

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with Romania reporting among the highest rates in the European Union. Regional outcome data remain scarce. Methods: We performed a retrospective cohort study of 302 patients with surgically treated colorectal adenocarcinoma at a Romanian tertiary hospital between 2003 and 2005, with a median follow-up of 60 months. Survival was analyzed using Kaplan–Meier and Cox regression. Results: Radical resection with R0 margins was achieved in 72% of cases. The overall 5-year survival was 38%, with significantly lower outcomes in advanced stages. Independent predictors of poor prognosis included advanced stage, emergency surgery, incomplete resection, and older age. Conclusions: Survival outcomes in this Romanian cohort were substantially lower than those reported in Western Europe, reflecting the burden of late-stage presentation. These findings emphasize the urgent need for nationwide CRC screening programs and wider access to modern multimodal therapies.

Topics & Concepts

MedicineCohortColorectal cancerRetrospective cohort studyInternal medicineCohort studyProportional hazards modelCancerOverall survivalOncologyAdenocarcinomaGeneral surgerySurvival analysisColorectal adenocarcinomaRomanianResectionSurgeryStage (stratigraphy)Relative survivalSurvival rateEpidemiologyMEDLINECohort effectCause of deathCancer survivalColon adenocarcinomaColorectal Cancer Surgical TreatmentsColorectal Cancer Screening and DetectionColorectal Cancer Treatments and Studies