# Short-Term Surgical Outcomes of Curative Colorectal Resections from an Evolving Low-Volume Cancer Center in a Tier-2 City in India

## TL;DR

This study examines short-term surgical outcomes for colorectal cancer in a low-volume center in India, showing acceptable results despite resource constraints.

## Contribution

The study provides evidence that safe colorectal resections can be performed in low-volume centers in India.

## Key findings

- Margin-negative resections were achieved in 99.5% of cases.
- Optimal nodal yield was attained in 90.8% of patients.
- Perioperative mortality was 2.9% with acceptable morbidity rates.

## Abstract

Colorectal cancers (CRC) are the fourth most prevalent cancer in India. Treatment modalities range from surgery, chemotherapy, radiotherapy, targeted treatment, and immunotherapy, with surgery forming the cornerstone of curative treatment in combination with any of the above. We sought to explore the short-term surgical outcomes of curative colorectal resections from our center and compare them with the published outcomes elsewhere. This is a retrospective study of all colorectal cancers that underwent curative resections at our center, from 1st January 2017 to 31st October 2024. Patients were identified from a prospectively maintained surgical database and electronic medical records. The clinical, radiological, histopathological features, and 30-day surgical outcomes were evaluated. We identified 207 patients for the said duration, with the majority of them being males (60.9%, 126/207), left-sided tumors (70%, 145/207) and clinic-radiologically stage III cancers (66.2%, 137/207). Preoperative treatment was employed in 38.7% (80/207) patients who were mostly rectal primaries (78/80). A minimally invasive surgical (MIS) approach was attempted in 36 patients with a conversion rate of 16.7%. Extended resections were performed in 33 patients (15.9%). The median length of hospital stay was 7 days (range 5 to 34 days). We observed re-exploration rates of 7.2%, a readmission rate of 3.4%, major perioperative morbidity (Clavien-Dindo 3a or above) of 13%, and 30-day perioperative mortality of 2.9%. Margin-negative resections were achievable in almost all cases (99.5%, 206/207), and optimal nodal yield (12 or more) was attained in 90.8% (188/207). Our study provides preliminary evidence that safe colorectal resections, including extended resections, can be performed in low-volume and resource-constrained centers with acceptable perioperative morbidity.